INS and obstructive sleep apnea syndrome: The present study provided two potential mechanisms for hypoxia-induced metabolic derangements: first, decreased FFA uptake in myotubes exposed to hypoxia might, together with increased lipolysis in adipose tissue (19, 13), contribute to elevated levels of FFA in OSA patients (38) and lead to development of pancreatic β-cell dysfunction and insulin resistance in liver and muscle (17, 39, 40).