Association between glucose metabolism, the circadian cycle and hypoxia: Evaluation of the NPAS2 and Rev-Erb-α protein serum levels in obstructive sleep apnea patients – a pilot study

May 28, 2024Dental and medical problems

Links between sugar use, daily body rhythms, and low oxygen in sleep apnea: Levels of two time-keeping proteins in the blood

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Abstract

The mean NPAS2 protein level was significantly lower in the OSA group compared to healthy individuals (p = 0.017).

Patients with severe obstructive sleep apnea (OSA) had lower serum levels of NPAS2 protein compared to healthy controls.
A tendency for lower NPAS2 levels was observed in the OSA group compared to those with both OSA and diabetes mellitus type 2 (DM2), though this was not statistically significant (p = 0.094).
No significant differences in Rev-Erb-α protein concentrations were found among the groups.
A negative correlation was identified between the apnea-hypopnea index during rapid eye movement (REM) sleep and NPAS2 serum levels (r = -0.478; p = 0.002).
These findings suggest that NPAS2 protein may be linked to metabolic dysregulation in OSA patients, potentially influenced by REM sleep.

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BACKGROUND: Obstructive sleep apnea (OSA) is one of the risk factors for diabetes mellitus type 2 (DM2). As OSA is associated with the disruption of the circadian rhythm, it affects circadian clock proteins, including neuronal PAS domain protein 2 (NPAS2) and nuclear receptor subfamily 1 group D member 1 (Rev-Erb-α). These proteins have been shown to be related to metabolic abnormalities, i.a., insulin resistance.

OBJECTIVES: The present pilot study aimed to investigate the NPAS2 and Rev-Erb-α protein serum levels in the groups of patients with severe OSA and severe OSA+DM2 in comparison with healthy controls, taking into account correlations with polysomnography (PSG) parameters (e.g., oxygen saturation (SpO2) variables).

MATERIAL AND METHODS: A total of 40 participants were included in the study. They were split into 3 groups as follows: the OSA group (n = 17; apnea-hypopnea index (AHI) >30, no DM2); the OSA+DM2 group (n = 7; AHI > 30 and DM2); and the control group (n = 16; AHI < 5, no DM2). All participants underwent a nocturnal PSG examination and had their blood collected the following morning. The serum levels of NPAS2 and Rev-Erb-α proteins were assessed using the enzyme-linked immunosorbent assay (ELISA).

RESULTS: The mean NPAS2 protein level was significantly lower in the OSA group as compared to healthy individuals (p = 0.017). Additionally, the OSA group presented with lower NPAS2 protein levels as compared to the OSA+DM2 group, but only a tendency was observed (p = 0.094). No differences in the Rev-Erb-α protein concentration were noticed. Furthermore, a negative correlation between AHI during rapid eye movement (REM) sleep and the NPAS2 protein serum level was observed (r = -0.478; p = 0.002).

CONCLUSIONS: Serum NPAS2 protein might be involved in metabolic dysregulation present among OSA patients, while the mechanism itself may be associated with REM sleep.

Association between glucose metabolism, the circadian cycle and hypoxia: Evaluation of the NPAS2 and Rev-Erb-α protein serum levels in obstructive sleep apnea patients – a pilot study

Abstract

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