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Insulin secretion is increased in OSA and while this is partly due to the central obesity which is common in this condition, the levels are raised even when this is taken into account. This may be because of increased sympathetic stimulation of the beta cells in the pancreas.

Insulin resistance develops independently of the body mass index [15] and leads to an increase in low-density lipoproteins (LDL) and a fall in high-density lipoproteins (HDL). This combination taken with hypertension comprises the metabolic syndrome to which OSA appears to be a contributory factor [16].

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