Prediabetes Is Associated with Increased Prevalence of Sleep-Disordered Breathing

Journal of Clinical Medicine

on behalf of the ILERVAS Project Collaborators¹  Ricard Gavaldಠ Cristina Farràs-Sallés³  Cristina Hernández⁴  Rafael Simó⁴  Dídac Mauricio⁵  Carolina López-Cano⁶  Ariadna Sauret⁶  Liliana Gutiérrez-Carrasquilla⁶  Albert Lecube⁶  Enric Sánchez⁶  Ferran Barbé⁷  Reinald Pamplona⁷  Mireia Dalmases⁷  Esther Sapiña-Beltrán⁷  Francisco Purroy⁷  Gerard Torres⁷  Eva Castro-Boqué⁸  Elvira Fernández⁸  Marcelino Bermúdez-López⁸ 

[1] ;Amalfi Analytics, Polytechnic University of Catalonia, 08034 Barcelona, Spain;Applied Epidemiology Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), 25198 Lleida, Spain;Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, 25198 Lleida, Spain;University of Lleida, 25003 Lleida, Spain;Vascular and Renal Translational Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), 25198 Lleida, Spain;

关键词: apnea;    glycated hemoglobin;    hypopnea;    prediabetes;    obstructive sleep apnea;   

DOI  :  10.3390/jcm11051413

来源: DOAJ

【 摘 要 】

Type 2 diabetes leads to severe nocturnal hypoxemia, with an increase in apnea events and daytime sleepiness. Hence, we assessed sleep breathing parameters in the prediabetes stage. A cross-sectional study conducted on 966 middle-aged subjects without known pulmonary disease (311 patients with prediabetes and 655 controls with normal glucose metabolism) was conducted. Prediabetes was defined by glycated hemoglobin (HbA1c), and a nonattended overnight home sleep study was performed. Participants with prediabetes (n = 311) displayed a higher apnea–hypopnea index (AHI: 12.7 (6.1;24.3) vs. 9.5 (4.2;19.6) events/h, p < 0.001) and hypopnea index (HI: 8.4 (4.0;14.9) vs. 6.0 (2.7;12.6) events/h, p < 0.001) than controls, without differences in the apnea index. Altogether, the prevalence of obstructive sleep apnea was higher in subjects with prediabetes than in controls (78.1 vs. 69.9%, p = 0.007). Additionally, subjects with prediabetes presented impaired measurements of the median and minimum nocturnal oxygen saturation, the percentage of time spent with oxygen saturations below 90%, and the 4% oxygen desaturation index in comparison with individuals without prediabetes (p < 0.001 for all). After adjusting for age, sex, and the presence of obesity, HbA1c correlated with the HI in the entire population (r = 0.141, p < 0.001), and the presence of prediabetes was independently associated with the AHI (B = 2.20 (0.10 to 4.31), p = 0.040) as well as the HI (B = 1.87 (0.61 to 3.14), p = 0.004) in the multiple linear regression model. We conclude that prediabetes is an independent risk factor for an increased AHI after adjusting for age, sex, and obesity. The enhanced AHI is mainly associated with increments in the hypopnea events.

【 授权许可】

Unknown