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This Article Full Text Full Text (PDF) All Versions of this Article: JOE-09-0245v1 203/1/181    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Henley, D. E Articles by Lightman, S. L Search for Related Content PubMed PubMed Citation Articles by Henley, D. E Articles by Lightman, S. L

¹ Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, University of Bristol, Bristol BS1 3NY, UK
² Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Crawley 6009, Western Australia, Australia
³ , Departments of Respiratory Medicine
⁴ Clinical Biochemistry, University Hospitals Bristol, Bristol BS1 3NU, UK

(Correspondence should be addressed to D E Henley who is now at Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, 1st Floor, C-Block, Hospital Avenue, Nedlands, Western Australia 6009, Australia; Email: dhenley{at}cygnus.uwa.edu.au)

Apelin is a peptide hormone with cardiovascular and glucose homeostasis properties, and obstructive sleep apnea (OSA) is complicated by cardiovascular and metabolic comorbidities. Plasma apelin has not been previously assessed in OSA. We investigated the response of plasma apelin to a 2-h 75 g oral glucose tolerance test (OGTT) and the effect of 3 months compliant continuous positive airway pressure (CPAP) therapy in 15 obese males with newly diagnosed OSA. Plasma apelin and serum cortisol were recorded 10 minutely, while serum insulin and glucose were measured 30 minutely. Ten subjects had plasma apelin measured at intervals across a 24-h period to investigate for circadian variation in apelin levels, and this was repeated following 3 months compliant CPAP therapy. Fasting (0.342±0.038 vs 0.288±0.024 ng/ml, P=0.04), 30 min (0.399±0.035 vs 0.312±0.036 ng/ml, P=0.007) and 120 min (0.402±0.030 vs 0.259±0.024 ng/ml, P<0.001) apelin levels were reduced following CPAP. The area under curve for apelin OGTT response was lower post-CPAP (44.1±3.3 vs 35.8±2.3 ng/ml per min, P<0.001). Mean OGTT apelin levels showed a significant treatment effect (P=0.006) and a time effect (P<0.001), and the effect of time was different pre- versus post-CPAP (P=0.005). No significant variability in apelin levels existed across the 24-h period at diagnosis. Lower levels were evident overnight following treatment (P=0.004). Improvements in insulin and glucose parameters and reduced cortisol levels were found post-CPAP. In summary, untreated OSA was associated with elevated plasma apelin levels, altered apelin secretory dynamics in response to oral glucose and lack of an apparent circadian variability, which was restored following CPAP.