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Original article
DOI: 10.1016/j.medcle.2020.05.052
Impact of sleep apnoea-hypopnoea syndrome on diabetic neuropathy. A systematic review
Impacto del síndrome de apnea-hipopnea del sueño en la neuropatía diabética. Revisión sistemática
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Romina Abelleiraa,
Corresponding author
abelleiraparis@hotmail.com

Corresponding author.
, Carlos Zamarróna, Alberto Ruanob,c,d, Tamara Louridoa, Nuria Rodríguez-Núñeza, Francisco J. González-Barcalaa,e, María E. Toubesa, José M. Álvarez-Dobañoa,e, Jorge Ricoya, Luis Valdésa,e
a Servicio de Neumología, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
b Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
c CIBER de Epidemiología y Salud Pública, CIBERESP, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
d Grupo de Epidemiología, Salud Pública y Evaluación de Servicios de Salud, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
e Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
Received 12 January 2020. Accepted 14 May 2020
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Figures (1)
Tables (3)
Table 1. Quality scale used to evaluate the included studies.
Table 2. Characteristics of the included studies.
Table 3. Clinicodemographic characteristics of patients included in the selected studies, comparing the OSAHS population with the non-OSAHS.
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Abstract
Introduction

Diabetes mellitus and sleep apnoea-hypopnoea syndrome appear to be related, but it is not well defined whether there is an increased risk of peripheral neuropathy in patients with both diseases. For this reason, we conducted a systematic review.

Methods

Bibliographic search in 3 electronic databases using a predefined strategy and the PRISMA methodology. Only original studies (any type of design) published from 2000 onwards in English, French, Portuguese or Spanish were included. A study quality scale was established.

Results

Twelve articles were selected, of which six studied type 2 diabetic patients. The overall prevalence of sleep apnoea-hypopnoea syndrome was 43.7% (1,559/3,564 patients). Diabetic neuropathy was more frequent in patients with sleep apnoea-hypopnoea syndrome in nine studies, although significantly only in four (60% vs 27%, p < .001; 64.5% vs 36%, p = .03; 37% vs 23.4%, p < .02; 66.6% vs 0%, p = .007). In one study, DN was more frequent in patients without SAHS (although not statistically significant) and in two no comparison was made between patients with/without sleep apnoea/hypopnoea syndrome.

Conclusions

The observed results suggest a relationship between diabetes mellitus and sleep apnoea-hypopnoea syndrome in the occurrence of diabetic neuropathy.

Keywords:
Obstructive Sleep Apnoea Hypopnoea Syndrome
Diabetes Mellitus
Diabetic Neuropathy
Resumen
Introducción

La diabetes mellitus y el síndrome de apnea-hipopnea del sueño parecen estar relacionados, pero no está bien definido si en los pacientes con ambas enfermedades existe un mayor riesgo de neuropatía periférica. Para ello, realizamos una revisión sistemática.

Métodos

Búsqueda bibliográfica en 3 bases de datos electrónicas usando una estrategia predefinida y la metodología PRISMA. Solamente se incluyeron estudios originales (cualquier tipo de diseño) y publicados a partir del año 2000 en inglés, francés, portugués o español. Se estableció una escala de calidad de los estudios.

Resultados

Se seleccionaron 12 artículos, de los que 6 estudiaban pacientes diabéticos tipo 2. La prevalencia global de síndrome de apnea-hipopnea del sueño fue del 43,7% (1.559/3.564 pacientes). La neuropatía diabética fue más frecuente en los pacientes con síndrome de apnea-hipopnea del sueño en nueve estudios, aunque solo en cuatro de manera significativa (60% vs 27%, p < 0,001; 64,5% vs 36%, p = 0,03; 37% vs 23,4%, p < 0,02; 66,6% vs 0%, p = 0,007). En un estudio, la ND fue más frecuente en los pacientes sin SAHS (aunque sin significación estadística) y en dos no se hizo la comparación entre pacientes con/sin síndrome de apnea-hipopnea del sueño.

Conclusiones

Los resultados observados sugieren una relación entre diabetes mellitus y síndrome de apnea-hipopnea del sueño en la aparición de neuropatía diabética.

Palabras clave:
Síndrome apnea-hipopnea obstructiva del sueño
Diabetes mellitus
Neuropatía Diabética

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