RELATIONSHIP BETWEEN INSULIN RESISTANCE AND RIGHT VENTRICULAR DYSFUNCTION IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA
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Keywords
Obstructive sleep apnea, insulin resistance, right ventricular dysfunction
Abstract
Obstructive sleep apnea (OSA) is strongly associated with cardiometabolic dysfunction, particularly insulin resistance and right ventricular (RV) impairment due to chronic intermittent hypoxia and sympathetic activation. The present community-based clinical study aimed to investigate the relationship between insulin resistance and right ventricular dysfunction in patients with OSA. A total of 220 participants, including 160 patients with polysomnography-confirmed OSA and 60 matched controls, were enrolled. Insulin resistance was assessed using the HOMA-IR index, while RV function was evaluated through echocardiographic parameters including tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC), and RV myocardial performance index (MPI). Serum inflammatory markers including CRP, albumin, and lipid profile were also analyzed to explore metabolic correlation patterns. Results demonstrated that patients with moderate-to-severe OSA exhibited significantly higher HOMA-IR values and impaired RV systolic and diastolic function compared to controls (p<0.001). Insulin resistance showed a strong inverse correlation with TAPSE and RVFAC, while a positive correlation was observed with RV MPI (p<0.001). Multivariate regression confirmed insulin resistance as an independent predictor of RV dysfunction even after adjusting for BMI, age, and OSA severity. The study concludes that insulin resistance plays a central role in the pathophysiology of RV dysfunction in OSA patients, highlighting the need for early metabolic screening to prevent cardiopulmonary complications.
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