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Inicio Medicina Clínica (English Edition) Relationship between obstructive sleep apnea and type 2 diabetes mellitus
Journal Information
Vol. 162. Issue 8.
Pages 363-369 (April 2024)
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Vol. 162. Issue 8.
Pages 363-369 (April 2024)
Original article
Relationship between obstructive sleep apnea and type 2 diabetes mellitus
Relación entre la apnea obstructiva del sueño y la diabetes mellitus tipo 2
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164
Romina Abelleiraa,
Corresponding author
abelleiraparis@hotmail.com

Corresponding author.
, Carlos Zamarróna, Vanessa Riveiroa, Ana Casala, María Elena Toubesa, Carlos Rábadea, Jorge Ricoya, Adriana Lamaa, Nuria Rodríguez-Núñeza, Lucía Ferreiroa,b, Juan Rodríguez-Ozoresa, Luis Valdésa,b,c
a Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
b Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain
c Departamento de Medicina, Facultad de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
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Tables (6)
Table 1. Patient characteristics.
Table 2. Characteristics of patients who develop DM or pre-DM during follow-up.
Table 3. Cumulative incidence of diabetes and pre-diabetes in relation to OSA severity level.a
Table 4. Stratification of BMI, presence or absence of OSA and development of DM.
Table 5. Model fit and effect of predictors expressed as RR and 95% CI for DM.
Table 6. Model fit and effect of predictors expressed as RR and 95% CI for DM.
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Abstract
Introduction

The association between obstructive sleep apnea (OSA) and glucose metabolism remains controversial. This study investigates the relationship between OSA and incident type 2 diabetes (DM) and prediabetes (preDM), as well as the effect of long-term CPAP (continuous positive airway pressure) treatment.

Methods

Follow-up study in a retrospective clinical cohort of patients with OSA and randomly selected controls. Data on incident DM and preDM as well as CPAP were obtained from hospital records. The relationship between baseline OSA and incident DM was examined using COX regression models.

Results

356 patients, 169 with OSA and 187 controls were followed for a median of 98 months; 47 patients (13.2%) developed DM and 43 (12.1%) developed pre-DM. The 5-year cumulative incidence of DM was 10.7% (6.5–13.9%). 87% of subjects with preDM in the baseline sample progressed to incident DM. It is shown that body mass index (BMI), nocturnal hypoxia and apnea hypopnea index (AHI) are risk factors for the development of DM and that CPAP reduces this risk.

Conclusions

Patients with OSA have a higher risk of developing DM. The risk factors involved are BMI, nocturnal hypoxia and AHI. Regular long-term CPAP use was associated with a decreased risk.

Keywords:
Obstructive apneas
Obstructive sleep apnea
Continuous positive airway pressure
Mellitus diabetes
Prediabetes
Respiratory polygraphy
Resumen
Introducción

La asociación entre la apnea obstructiva del sueño (AOS) y el metabolismo de la glucosa sigue siendo controvertida. Este estudio investiga la relación entre la AOS y la diabetes tipo 2 (DM) y prediabetes (preDM) incidentes, así como el efecto del tratamiento con CPAP (presión positiva continua en la vía aérea) a largo plazo.

Métodos

Estudio de seguimiento en cohorte retrospectiva clínica de pacientes con AOS y controles seleccionados de manera aleatoria. Los datos sobre DM incidente y preDM, así como sobre la CPAP se obtuvieron de los registros hospitalarios. La relación entre AOS basal y la DM incidente se examinó utilizando modelos de regresión de COX.

Resultados

De un total de 356 pacientes, 169 con AOS y 187 controles fueron seguidos por una mediana de 98 meses; 47 enfermos (13,2%) desarrollaron DM y 43 (12,1%) preDM. La incidencia acumulada a los cinco años de DM fue de 10,7% (6,5–13,9%). De los sujetos con preDM en la muestra basal, 87% evolucionaron a DM incidente. Se demuestra que el índice de masa corporal (IMC), la hipoxia nocturna y el índice de apnea hipopnea (IAH) son factores de riesgo para el desarrollo de DM, y que la CPAP los disminuye.

Conclusiones

Los pacientes con AOS tienen mayor riesgo de desarrollar DM. Los factores de riesgo implicados son el IMC, la hipoxia nocturna y el IAH. El uso regular de CPAP a largo plazo se asoció con una disminución del riesgo.

Palabras clave:
Apneas obstructivas
Apnea obstructiva del sueño
Presión positiva continua en las vías aéreas
Diabetes mellitus
Prediabetes
Poligrafía respiratoria

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