Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
Sleep and Breathing
Published in: Sleep and Breathing 1/2012

01-03-2012 | Original Article

The impact of insulin resistance and hyperandrogenemia on polysomnographic variables in obese adolescents with polycystic ovarian syndrome

Authors: Gideon de Sousa, Bernhard Schlüter, Dirk Buschatz, Thomas Menke, Eckardt Trowitzsch, Werner Andler, Thomas Reinehr

Published in: Sleep and Breathing | Issue 1/2012

Login to get access

Abstract

Purpose

We aimed to determine the impact of insulin resistance and hyperandrogenemia on polysomnographic variables in obese adolescents with polycystic ovarian syndrome (PCOS), as studies in adults with PCOS suggest that parameters of glucose metabolism and serum androgens are related to respiratory polysomnographic variables (RPV), and the symptoms of PCOS usually begin around menarche.

Methods

We divided our study group of obese adolescents with PCOS according to HOMA-index and in a second analysis according to free androgen index (FAI). Study group A consisted of 14 girls with HOMA-index <4, study group B of 17 girls with HOMA-index >4. Study group C consisted of 19 girls with FAI <10, and study group D of 18 girls with FAI >10. The control group for both analyses consisted of 19 healthy obese adolescents without PCOS. All girls underwent overnight 12-channel polysomnography.

Results

In both analyses, we found no differences between the groups concerning the RPV. Study group B demonstrated a significantly lower percentage of REM-sleep than the control group (p = 0.02). Study group D demonstrated a significantly lower percentage sleep stages 3 and 4 of non-REM-sleep than study group C and the controls (p = 0.008). Study group D demonstrated significantly lower sleep efficiency than the controls (p = 0.03).

Conclusions

Insulin resistance and hyperandrogenemia do not seem to have a significant impact on RPV in obese adolescents with PCOS. Differences in sleep architecture found between patients with PCOS and controls, however, are possibly influenced by insulin resistance and/or serum androgens.
Literature
1.
Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R (1998) Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab 83:3078–3082PubMedCrossRef
2.
Zawadski JK, Dunaif A (1992) Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine FP, Merriam GR (eds) polycystic ovary syndrome. Blackwell Scientific Publications, Boston, pp 377–384
3.
Sam S, Dunaif A (2003) Polycystic ovary syndrome: syndrome XX? Trends Endocrinol Metab 14:365–370PubMedCrossRef
4.
5.
Fogel RB, Malhotra A, Pillar G, Pittman SD, Dunaif A, White DP (2001) Increased prevalence of obstructive sleep apnea syndrome in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab 86:1175–1180PubMedCrossRef
6.
Vgontzas AN, Legro RS, Bixler EO, Grayev A, Kales A, Chrousos GP (2001) Polycystic ovary syndrome is associated with obstructive sleep apnea and daytime sleepiness: role of insulin resistance. J Clin Endocrinol Metab 86:517–520PubMedCrossRef
7.
Gopal M, Duntley S, Uhles M, Attarian H (2002) The role of obesity in the increased prevalence of obstructive sleep apnea syndrome in patients with polycystic ovarian syndrome. Sleep Med 3:401–404PubMedCrossRef
8.
Tasali E, Van Cauter E, Hoffman L, Ehrmann DA (2008) Impact of obstructive sleep apnea on insulin resistance and glucose tolerance in women with polycystic ovary syndrome. J Clin Endocrinol Metab 93:3878–3884PubMedCrossRef
9.
Tasali E, Van Cauter E, Ehrmann DA (2006) Relationship between sleep disordered breathing and glucose metabolism in polycystic ovary syndrome. J Clin Endocrinol Metab 91:36–42PubMedCrossRef
10.
Subramanian S, Desai A, Joshipura M, Surani S (2007) Practice patterns of screening for sleep apnea in physicians treating PCOS patients. Sleep Breath 11:233–237PubMedCrossRef
11.
Yaggi HK, Concato J, Kernan WN et al (2005) Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 353:2034–2041PubMedCrossRef
12.
de Sousa G, Schlüter B, Buschatz D, Menke T, Trowitzsch E, Andler W, Reinehr T (2010) A comparison of polysomnographic variables between obese adolescents with polycystic ovarian syndrome and healthy, normal-weight and obese adolescents. Sleep Breath 14:33–38PubMedCrossRef
13.
Sawathiparnich P, Weerakulwattana L, Santiprabhob J, Likitmaskul S (2005) Obese adolescent girls with polycystic ovary syndrome (PCOS) have more severe insulin resistance measured by HOMA-IR score than obese girls without PCOS. J Med Assoc Thai 88:S33–S37PubMed
14.
Silfen ME, Denburg MR, Manibo AM, Lobo RA, Jaffe R, Ferin M, Levine LS, Oberfield SE (2003) Early endocrine, metabolic, and sonographic characteristics of polycystic ovary syndrome (PCOS): comparison between nonobese and obese adolescents. J Clin Endocrinol Metab 88:4682–4688PubMedCrossRef
15.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419PubMedCrossRef
16.
Reinehr T, Andler W (2004) Changes in the atherogenic risk factor profile according to degree of weight loss. Arch Dis Child 89:419–422PubMedCrossRef
17.
Fu-yuan Q, Lauritzen C (1990) Die Bedeutung des sexualhormonbindenden Globulin und des freien Androgen-Index für die Beurteilung androgenetischer Krankheitsbinder. J Huazhong University of Sci Technol 10:124–128
18.
Cole TJ, Belizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320:1240–1243PubMedCrossRef
19.
Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß HC, Hesse V, von Hippel A, Jaeger U, Johnsen D, Korte W, Menner K, Müller G, Müller MJ, Niemann-Pilatus A, Remer T, Schaefer F, Wittchen HU, Zabransky S, Zellner K, Ziegler A, Hebebrand J (2001) Percentiles of body mass index in children and adolescents evaluated from different regional German studies. Monatsschr Kinderheilkd 149:807–818CrossRef
20.
Cole TJ (1990) The LMS method for constructing normalized growth standards. Eur J Clin Nutr 44:45–60PubMed
21.
Reinehr T, de Sousa G, Roth CL, Andler W (2005) Androgens before and after weight loss in obese children. J Clin Endocrinol Metab 90:5588–5595PubMedCrossRef
22.
Rechtschaffen A, Kales A (1968) A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. U.S. Government Printing Office, Washington DC
23.
AASM (1992) EEG arousals: scoring rules and examples. A preliminary report from the sleep disorders atlas task force of the American Sleep Disorders Association. Sleep 15:174–184
24.
AASM (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 22:667–689
25.
Marin JM, Carrizo SJ, Vincente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea–hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365:1046–1053PubMed
26.
Whittle AT, Marshall I, Mortimore IL, Wraith PK, Sellar RJ, Douglas NJ (1999) Neck soft tissue and fat distribution: comparison between normal men and women by magnetic resonance imaging. Thorax 54:323–328PubMedCrossRef
27.
Sheridan PJ, Weaker FJ (1982) Androgen receptor systems in the brain stem of the primate. Brain Res 235:225–232PubMedCrossRef
28.
Popovic RM, White DP (1995) Influence of gender on waking genioglossal electromyogram and upper airway resistance. Am J Respir Crit Care Med 152:725–731PubMed
29.
Barrett-Connor E, Dam TT, Stone K, Harrison SL, Redline S, Orwoll E (2008) The association of testosterone levels with overall sleep quality, sleep architecture, and sleep-disordered breathing. J Clin Endocrinol Metab 93:2602–2609PubMedCrossRef
30.
Liu PY, Yee B, Wishart SM, Jimenez M, Jung DG, Grunstein RR, Handelsman DJ (2003) The short-term effects of high-dose testosterone on sleep, breathing, and function in older men. J Clin Endocrinol Metab 88:3605–3613PubMedCrossRef
31.
Andersen ML, Tufik S (2008) The effects of testosterone on sleep and sleep-disordered breathing in men: its bidirectional interaction with erectile function. Sleep Med Rev 12:365–379PubMedCrossRef
32.
Rao MN, Blackwell T, Redline S, Stefanick ML, Ancoli-Israel S, Stone KL (2009) Association between sleep architecture and measures of body composition. Sleep 32:483–490PubMed
33.
Kranke P, Schuster F, Muellenbach R, Kranke EM, Roewer N, Smul T (2008) Grundlagen und Prinzipien klinischer Studien: Wie viele Patienten sollen (müssen) untersucht werden? KARDIOTECHNIK 4:114–117
Metadata
Title
The impact of insulin resistance and hyperandrogenemia on polysomnographic variables in obese adolescents with polycystic ovarian syndrome
Authors
Gideon de Sousa
Bernhard Schlüter
Dirk Buschatz
Thomas Menke
Eckardt Trowitzsch
Werner Andler
Thomas Reinehr
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
Sleep and Breathing / Issue 1/2012
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-010-0469-6

Other articles of this Issue 1/2012

Sleep and Breathing 1/2012 Go to the issue

Report

Pycnodysostosis with extreme sleep apnea: a possible alternative to tracheotomy

Original Article

Sleep apnea symptoms and accident risk factors in Persian commercial vehicle drivers

Original Article

Early cardiac abnormalities and increased C-reactive protein levels in a cohort of children with sleep disordered breathing

Original Article

Prevalence and treatment of central sleep apnoea emerging after initiation of continuous positive airway pressure in patients with obstructive sleep apnoea without evidence of heart failure

Original Article

Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P)

Original Article

Differential respiratory control of the upper airway and diaphragm muscles induced by 5-HT1A receptor ligands
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits