{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T04:45:14Z","timestamp":1759812314013,"version":"build-2065373602"},"reference-count":41,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T00:00:00Z","timestamp":1759622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004442","name":"National Science Centre","doi-asserted-by":"crossref","award":["2021\/41\/N\/NZ5\/00486"],"award-info":[{"award-number":["2021\/41\/N\/NZ5\/00486"]}],"id":[{"id":"10.13039\/501100004442","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["IJMS"],"abstract":"<jats:p>Obstructive sleep apnea (OSA) is a chronic respiratory disorder characterized by intermittent hypoxia and is strongly associated with the development of type 2 diabetes mellitus (T2DM). Despite this link, the molecular mechanisms underlying OSA-related metabolic dysregulation remain incompletely understood. The aim of the study was to investigate the role of hypoxia-sensitive microRNAs, sirtuin 1 (SIRT1), and adiponectin in the metabolic profile of OSA patients, with and without T2DM. A total of 87 participants were stratified into three groups: OSA, OSA + T2DM, and healthy controls. Blood samples were collected in the evening and morning, and after continuous positive airway pressure (CPAP) therapy. Expression levels of miRNAs and SIRT1 were measured via RT-qPCR; adiponectin was quantified by ELISA. Significantly reduced expression of miRNA-181a and miRNA-199a was observed in the OSA + T2DM group compared to OSA (p = 0.035 and p = 0.042, respectively). In contrast, SIRT1 expression was highest in the OSA + T2DM group (p &lt; 0.01), while adiponectin concentrations was lowest in this group and the highest among healthy controls (p = 0.001). Despite increased SIRT1 in OSA + T2DM patients, the parallel increase in adiponectin was not observed. Additionally, expression of SIRT1 was significantly increased in OSA patients who were taking metformin (n = 23) vs. patients without metformin (n = 32) 77.315 vs. 437.08 (p = 0.037). CPAP therapy had significant influence only on miRNA-181a\u2014expression was increased after long-term treatment (p = 0.047). Increased miRNA-181a expression in patients with OSA is related to decreased SIRT1 expression, which may lead to T2DM development. Surprisingly, the expression of SIRT1 is significantly higher and expression of hypoxia-sensitive miRNAs is significantly lower in patients with already developed T2DM, which might be explained by metformin intake.<\/jats:p>","DOI":"10.3390\/ijms26199699","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T15:05:06Z","timestamp":1759763106000},"page":"9699","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of Hypoxia-Sensitive miRNA181a, miRNA199a, SIRT1, and Adiponectin in Diabetes Mellitus Type 2 Development in Obstructive Sleep Apnea Patients"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6551-6804","authenticated-orcid":false,"given":"Filip Franciszek","family":"Karuga","sequence":"first","affiliation":[{"name":"Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Kaczmarski","sequence":"additional","affiliation":[{"name":"Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2122-0304","authenticated-orcid":false,"given":"Marcin","family":"Sochal","sequence":"additional","affiliation":[{"name":"Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bartosz","family":"Szmyd","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Neuro-Oncology, Barlicki University Hospital, Medical University of Lodz, 90-419 Lodz, Poland"},{"name":"Department of Pediatrics, Oncology, and Hematology, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greta Veronika","family":"Urbonait\u0117","sequence":"additional","affiliation":[{"name":"Clinical Department of Radiotherapy, Radom Oncology Center, 26-600 Radom, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Szymon","family":"Turkiewicz","sequence":"additional","affiliation":[{"name":"Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Bia\u0142asiewicz","sequence":"additional","affiliation":[{"name":"Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4430-6488","authenticated-orcid":false,"given":"Agata","family":"Gabryelska","sequence":"additional","affiliation":[{"name":"Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.smrv.2007.11.003","article-title":"Gender Differences in Obstructive Sleep Apnea and Treatment Implications","volume":"12","author":"Lin","year":"2008","journal-title":"Sleep Med. 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