Relationship Between Intermittent Hypoxia and Type 2 Diabetes in Sleep Apnea Syndrome

Int J Mol Sci. 2019 Sep 25;20(19):4756. doi: 10.3390/ijms20194756.

Abstract

Sleep apnea syndrome (SAS) is a very common disease involving intermittent hypoxia (IH), recurrent symptoms of deoxygenation during sleep, strong daytime sleepiness, and significant loss of quality of life. A number of epidemiological researches have shown that SAS is an important risk factor for insulin resistance and type 2 diabetes mellitus (DM), which is associated with SAS regardless of age, gender, or body habitus. IH, hallmark of SAS, plays an important role in the pathogenesis of SAS and experimental studies with animal and cellular models indicate that IH leads to attenuation of glucose-induced insulin secretion from pancreatic β cells and to enhancement of insulin resistance in peripheral tissues and cells, such as liver (hepatocytes), adipose tissue (adipocytes), and skeletal muscles (myocytes). In this review, we focus on IH-induced dysfunction in glucose metabolism and its underlying molecular mechanisms in several cells and tissues related to glucose homeostasis.

Keywords: adipokines; glucose-induced insulin secretion; hepatokines; intermittent hypoxia; myokines; pancreatic β cell proliferation; sleep apnea syndrome; type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Adipose Tissue / metabolism
  • Animals
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / etiology*
  • Diabetes Mellitus, Type 2 / metabolism*
  • Glucose / metabolism
  • Humans
  • Hypoxia / complications*
  • Hypoxia / epidemiology
  • Hypoxia / metabolism*
  • Insulin / metabolism
  • Insulin Resistance
  • Insulin-Secreting Cells / metabolism
  • Liver / metabolism
  • Muscle, Skeletal / metabolism
  • Nerve Tissue / metabolism
  • Organ Specificity
  • Sleep Apnea Syndromes / complications*
  • Sleep Apnea Syndromes / epidemiology

Substances

  • Insulin
  • Glucose