{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T07:08:15Z","timestamp":1778569695715,"version":"3.51.4"},"reference-count":48,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2019,5,20]],"date-time":"2019-05-20T00:00:00Z","timestamp":1558310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular and metabolic risk factors, such as insulin resistance. Furthermore, OSAS has been associated with decreased levels of vitamin D (Vit D). The aim of the study was to assess the association between Vit D levels (expressed as 25(OH)D serum levels) and insulin resistance in patients with OSAS. Materials and Methods: Serum 25(OH)D levels were measured in consecutive subjects who had undergone polysomnography and pulmonary function testing. OSAS patients were divided into those with (homeostatic model assessment [HOMA-IR] \u2265 2) and without insulin resistance (HOMA-IR &lt; 2). Results: Overall, 92 patients (81 males) were included in the study. OSAS patients with insulin resistance significantly differed from those without insulin resistance in terms of the body-mass index (BMI) (36.3 \u00b1 5.8 compared to 32 \u00b1 5.6 kg\/m2, respectively, p = 0.001), apnoea-hypopnoea index (AHI) (57.4 \u00b1 28.9 compared to 40.9 \u00b1 27.9 events\/h, respectively, p = 0.009) and indices of hypoxia during sleep. Patients with OSAS and insulin resistance had lower levels of serum 25 (OH) D compared with OSAS but without insulin resistance (19.3 \u00b1 11.5 vs 26.7 \u00b1 12.2 ng\/mL, respectively, p = 0.005). Regression analysis demonstrated a negative association of 25(OH)D levels (\u03b2 = \u22120.048, odds ratio [OR]: 0.953, 95% confidence interval [CI]: 0.913\u20130.995, p = 0.030) and a positive association of BMI (\u03b2 = 0.110, OR: 1.116, 95% CI: 1.007\u20131.237, p = 0.036) with insulin resistance. Conclusions: Vit D insufficiency was significantly more frequent among OSAS patients with insulin resistance. Both low 25(OH)D levels and high BMI were associated with the risk of insulin resistance in this population.<\/jats:p>","DOI":"10.3390\/medicina55050174","type":"journal-article","created":{"date-parts":[[2019,5,21]],"date-time":"2019-05-21T10:52:51Z","timestamp":1558435971000},"page":"174","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Reduced Serum Vitamin D Levels Are Associated with Insulin Resistance in Patients with Obstructive Sleep Apnea Syndrome"],"prefix":"10.3390","volume":"55","author":[{"given":"Kostas","family":"Archontogeorgis","sequence":"first","affiliation":[{"name":"MSc Programme in Sleep Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Papanas","sequence":"additional","affiliation":[{"name":"Diabetes Centre, Second Department of Internal Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelos C.","family":"Rizos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0381-4715","authenticated-orcid":false,"given":"Evangelia","family":"Nena","sequence":"additional","affiliation":[{"name":"Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Athanasios","family":"Zissimopoulos","sequence":"additional","affiliation":[{"name":"Laboratory of Nuclear Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7869-6824","authenticated-orcid":false,"given":"Christina","family":"Tsigalou","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Athanasios","family":"Voulgaris","sequence":"additional","affiliation":[{"name":"MSc Programme in Sleep Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece"},{"name":"Department of Pneumonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitri P.","family":"Mikhailidis","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, University College London (UCL), NW3 2QG London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0505-078X","authenticated-orcid":false,"given":"Moses S.","family":"Elisaf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marios E.","family":"Froudarakis","sequence":"additional","affiliation":[{"name":"Department of Pneumonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7121-6253","authenticated-orcid":false,"given":"Paschalis","family":"Steiropoulos","sequence":"additional","affiliation":[{"name":"MSc Programme in Sleep Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece"},{"name":"Department of Pneumonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s13311-012-0145-6","article-title":"Classification of sleep disorders","volume":"9","year":"2012","journal-title":"Neurotherapeutics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1093\/aje\/kws342","article-title":"Increased prevalence of sleep-disordered breathing in adults","volume":"177","author":"Peppard","year":"2013","journal-title":"Am. 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