Insulin resistance mediates the elevatedrate of type 2 diabetes, chronic kidney disease, and cardiovascular diseaseunexplained with traditional cardiovascular risk factors present in OSA patients.Pathophysiological processes underlying hypoxia-induced insulin resistanceinvolve hypoxia inducible factor-1 upregulation and peroxisomeproliferator-activated receptor-gamma (PPAR-γ) downregulation. Here, INS is linked to chronic kidney disease.