Type 2 diabetes and pre-diabetes are associated with obstructive sleep apnea in extremely obese subjects: A cross-sectional study

Cardiovascular Diabetology

Original Investigation

Torbjørn Omland¹  Kristian Vegsgaard²  Jan Rollheim³  Jøran Hjelmesæth³  Dag Hofsø³  Jo Røislien⁴  Jan Magnus Fredheim⁵ 

[1] Department of Medicine, Akershus University Hospital, Lørenskog, Norway;Department of Otolaryngology - Head and Neck Surgery, Vestfold Hospital Trust, 3103, Tønsberg, Norway;Morbid Obesity Centre, Department of Medicine, Hospital Trust, 3103, Tønsberg, Norway;Morbid Obesity Centre, Department of Medicine, Hospital Trust, 3103, Tønsberg, Norway;Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, 0317, Oslo, Norway;Morbid Obesity Centre, Department of Medicine, Hospital Trust, 3103, Tønsberg, Norway;Department of Otolaryngology - Head and Neck Surgery, Vestfold Hospital Trust, 3103, Tønsberg, Norway;

关键词: Obstructive sleep apnea;    type 2 diabetes;    prediabetes;    oral glucose tolerance test;    inflammation;   

DOI  :  10.1186/1475-2840-10-84

 received in 2011-09-01, accepted in 2011-09-25,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundObstructive sleep apnea (OSA) is a common yet underdiagnosed condition. The aim of our study is to test whether prediabetes and type 2 diabetes are associated with obstructive sleep apnea (OSA) in extremely obese (BMI ≥ 40 kg/m2) subjects.MethodsOne hundred and thirty seven consecutive extremely obese patients (99 females) from a controlled clinical trial [MOBIL-study (Morbid Obesity treatment, Bariatric surgery versus Intensive Lifestyle intervention Study) (ClinicalTrials.gov number NCT00273104)] underwent somnography with Embletta® and a 2-hour oral glucose tolerance test (OGTT). OSA was defined by an apnea-hypopnea index (AHI) ≥ 5 events/hour. Patients were categorized into three groups according to criteria from the American Diabetes Association: normal glucose tolerance, pre-diabetes and type 2 diabetes. Multiple logistic regression analysis was used to identify possible determinants of OSA.ResultsThe patients had a mean (SD) age of 43 (11) years and a body mass index (BMI) of 46.9 (5.7) kg/m2. Males had significantly higher AHI than females, 29 (25) vs 12 (17) events/hour, p < 0.001. OSA was observed in 81% of men and in 55% of women, p = 0.008. Twenty-nine percent of subjects had normal glucose tolerance, 42% had pre-diabetes and 29% had type 2 diabetes. Among the patients with normal glucose tolerance 33% had OSA, while 67% of the pre-diabetic patients and 78% of the type 2 diabetic patients had OSA, p < 0.001. After adjusting for age, gender, BMI, high sensitive CRP and HOMA-IR, both pre-diabetes and type 2 diabetes were still associated with OSA, odds ratios 3.18 (95% CI 1.00, 10.07), p = 0.049 and 4.17 (1.09, 15.88), p = 0.036, respectively. Mean serum leptin was significantly lower in the OSA than in the non-OSA group, while other measures of inflammation did not differ significantly between groups.ConclusionsType 2 diabetes and pre-diabetes are associated with OSA in extremely obese subjects.Trial registrationMOBIL-study (Morbid Obesity treatment, Bariatric surgery versus Intensive Lifestyle intervention Study) (ClinicalTrials.gov number NCT00273104)

【 授权许可】

CC BY   
© Fredheim et al; licensee BioMed Central Ltd. 2011