Plasma levels of adiponectin, a novel adipocyte-derived hormone, in sleep apnea

Objective: Obstructive sleep apnea (OSA) is associated with obesity, sympathetic activation, systemic inflammation, and cardiovascular morbidity. Obesity, beta-adrenergic agonists, and inflammation are linked to decreased expression and/or secretion of an adipose tissue-derived antiatherogenic hormone, adiponectin. The purpose of the study was to investigate whether OSA affected plasma levels of adiponectin, which might help explain OSA-associated cardiovascular morbidity. Research Methods and Procedures: We randomly selected 68 otherwise healthy male subjects, either with moderate/ severe OSA [apnea-hypopnea index (AHI) >= 20; n = 35] or without OSA (AHI <= 5; n = 33). The diagnosis of OSA was made based on prospective full polysomnography. Adiponectin was measured before polysomnography between 8 and 10 Pm. Results: AHI was higher in the OSA group (49.5 +/- 4.4 vs. 2.9 +/- 0.4 events/h; p < 0.001). OSA subjects were also more obese, with greater BMI (33 +/- 1 vs. 30 1; p = 0.016) and percentage body fat (29 +/- 1% vs. 26 1%; p = 0.030). Adiponectin levels were 7.67 +/- 0.73 and 6.33 +/- 0.51 mu g/mL in the OSA and non-OSA groups, respectively, and this difference was significant in covariate analysis (taking into account age, hemodynamic characteristics, measures of body fat, and OSA severity) (p = 0.009). After excluding from both groups the subjects with extreme BMI, such that the OSA and non-OSA study cohorts had similar BMI and percentage body fat, subjects with OSA had significantly higher plasma adiponectin (8.49 +/- 0.92 vs. 6.32 +/- 0.55 mu g/mL; p = 0.042), differences also evident in covariate analysis (p = 0.017). Discussion: Plasma adiponectin levels are elevated in otherwise healthy subjects with OSA. Therefore, low adiponectin is unlikely to explain the association between OSA and cardiovascular disease.