Inflammatory Cross-Talk Between Short Sleep Duration and Obesity in Development of Insulin Resistance: Narrative Review

Purpose Obesity is characterized by increased infiltration of macrophages. Cytokines derived from these macrophages significantly induce inflammatory response and desensitize insulin action. Disturbed sleep pattern is also associated with release of the same kind of cytokines that could play a central role in the development of insulin resistance. Material and Methods A computer-based search of the literature indexed in PubMed was made using the keywords: glucose metabolism, insulin resistance, adipokines, adiponectin, interleukin-6 (IL-6), leptin, tumor necrosis factor alpha (TNF-α), monocyte chemo-attractant protein-1 (MCP-1), sleep deprivation, and sleep loss. In this review firstly we include the studies that have measured the relationship of cytokines with sleep duration and insulin resistance, and finally, we analyze the relationship of sleep duration with the development of insulin resistance and type 2 diabetes mellitus. Discussion IL-6, IL-1β, TNF-α, and MCP-1 are secreted by many cell types including macrophages, adipocytes, etc. They are released in response to many stimuli including sleep loss, tissue injury, and infection. Some evidence has suggested that these cytokines are molecular link between obesity, sleep disturbances, and insulin resistance, because similar types of alterations in plasma levels of these cytokines are found in patients with obesity and disturbed sleep having type 2 diabetes mellitus (DM-2) or insulin resistance. Conclusion We conclude that both sleep loss and obesity contribute to the onset of insulin resistance and DM-2 with the help of the same kind of cytokines. The mechanisms involved in the impaired glucose metabolism seem to act via a decreased efficacy of the hypothalamic–pituitary–adrenal (HPA) axis and due to modified release of cytokines—especially IL-1β, IL-6, TNF-α, and MCP-1 from adipocytes following obesity and poor quality of sleep. The aforementioned biomarkers could provide a minimally invasive means for early detection and specific treatment of these disorders.