Serednytskyy, OleksandrAlonso-Fernandez, AlbertoRibot Quetglas, CaterinaHerranz Mochales, AndreaÁlvarez Valdivielso, AinhoaSanchez, AndresRodriguez, PaulaGil, Ana VPia, CarlaCubero, Jose PBarcelo, MariaCerda Moncadas, MariaCodina Marcet, MercedesPena, Monica DBarceló Bennasar, AntoniaIglesias, AmandaMorell Garcia, DanielPena, Jose AGimenez, Maria PPinas, Maria CGarcia-Rio, Francisco2024-10-042024-10-042022-03-18Serednytskyy O, Alonso-Fernandez A, Ribot C, Herranz A, Alvarez A, Sanchez A, et al. Systemic inflammation and sympathetic activation in gestational diabetes mellitus with obstructive sleep apnea. BMC Pulm Med. 2022 Mar 18;22(1):94.1471-2466https://hdl.handle.net/20.500.13003/19842https://hdl.handle.net/20.500.12105/23534Background: Although some evidence suggests an association between obstructive sleep apnea (OSA) and gestational diabetes mellitus (GDM), its consequences still remain largely unknown. We sought to determine whether OSA is associated with higher inflammation and sympathetic levels in GDM, and to relate them with insulin resistance and perinatal outcomes. Methods: OSA was identified by polysomnography and defined as an apnea-hypopnea index of ≥ 5 h-1. Plasma cytokines (TNF-α, IL-1β, IL-6, IL-8, IL-10), metanephrine, and normetanephrine were determined by immunoassays. Results: We included 17 patients with GDM and OSA and 34 without OSA. Women with GDM and OSA had higher normetanephrine concentrations [81 IQR (59-134) vs. 68 (51-81) pg/mL]. No differences in the inflammatory profile were found, while IL-1β was higher in patients with mean nocturnal oxyhemoglobin saturation ≤ 94%. We found positive correlations between increased sympathetic activation and IL-1β, with obstructive apneas, while time in REM showed an inverse relationship with IL-1β and metanephrine. Furthermore, IL-10 was inversely related with time in sleep stages 1-2, and with the arousal index, and it was positively related with time in slow-wave sleep. Significant correlations were also found between IL-1β and insulin resistance. There were no significant differences in neonatal characteristics; however, we found inverse relationships between IL-10 and birth weight (BW), and percentile of BW. Conclusions: OSA increased sympathetic activity, and IL-1β concentration was higher in patients with GDM with lower nocturnal oxygenation, all of which were related with obstructive events, and time in REM. Moreover, IL-1β was related with insulin resistance, and IL-10 inversely correlated with neonatal BW.enghttp://creativecommons.org/licenses/by/4.0/Gestational diabetes mellitusFetal outcomesCytokineinflammationMetanephrineNormetanephrineObstructive sleep apneaPregnancyPolysomnographyInfant, NewbornFemaleSleep Apnea, ObstructiveHumansInflammationDiabetes, GestationaInsulin Resistanceresearch articleAttribution 4.0 International353038332219410.1186/s12890-022-01888-1BMC Pulmonary Medicineopen accessDiabetes GestacionalApnea Obstructiva del SueñoHumanosInflamaciónEmbarazoRecién NacidoFemeninoResistencia a la InsulinaPolisomnografía2-s2.0-85126650324770623700002L2015360659