The Relationship between Diabetic Neuropathy and Sleep Apnea Syndrome: A Meta-Analysis.
The Relationship between Diabetic Neuropathy and Sleep Apnea Syndrome: A Meta-Analysis.
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作者：
Fujihara K;Kodama S;Horikawa C;Yoshizawa S;Sugawara A;Hirasawa R;Shimano H;Yachi Y;Suzuki A;Hanyu O;Sone H
目标。据报道，糖尿病患者中睡眠呼吸暂停综合征 (SAS) 的患病率很高。然而，糖尿病神经病变（DN）是否导致这种高患病率存在争议。我们本研究的目的是比较患有和不患有 DN 的患者之间 SAS 的患病率。方法。使用MEDLINE（从1966年至2012年11月5日）和EMBASE（从1974年至2012年11月5日）对报告DN和SAS患者数量的横断面研究进行系统文献检索。使用 Mantel-Haenszel 方法汇总与 DN 相关的 SAS 的优势比 (OR)。结果。数据来自 5 项符合条件的研究（包括 6 个数据集、880 名受试者和 429 例病例）。总体而言，与非 DN 患者相比，DN 患者 SAS 的汇总 OR 显着（OR (95% CI)，-1.95 (1.03–3.70)）。 2 型糖尿病患者中 SAS 的汇总 OR 为 1.90 (0.97–3.71)。排除 1 型糖尿病患者的数据，年轻患者（平均年龄 <60 岁）的 OR 高于 60 岁以上的患者，其中 OR 仍然显着（3.82；95% CI，2.24-6.51 和 1.17；95% CI，0.81-1.68）。结论。目前的荟萃分析表明，神经病变的某些因素与 2 型糖尿病中的 SAS 存在关联。需要进一步研究来澄清这种关联是否也适用于 1 型糖尿病患者。
Aims. High prevalence of sleep apnea syndrome (SAS) has been reported in patients with diabetes. However, whether diabetic neuropathy (DN) contributes to this high prevalence is controversial. Our aim of this study is to compare the prevalence of SAS between patients with and without DN. Methods. Systematic literature searches were conducted for cross-sectional studies that reported the number of patients with DN and SAS using MEDLINE (from 1966 to Nov 5, 2012) and EMBASE (from 1974 to Nov 5, 2012). Odds ratios (ORs) of SAS related to DN were pooled with the Mantel-Haenszel method. Results. Data were obtained from 5 eligible studies (including 6 data sets, 880 participants, and 429 cases). Overall, the pooled OR of SAS in patients with DN compared with that in non-DN patients was significant (OR (95% CI), −1.95 (1.03–3.70)). The pooled OR of SAS was 1.90 (0.97–3.71) in patients with type 2 diabetes. Excluding data on patients with type 1 diabetes, a higher OR was observed in younger patients (mean age <60 years) than in those ≥60 years among whom the OR remained significant (3.82; 95% CI, 2.24–6.51 and 1.17; 95% CI, 0.81–1.68). Conclusions. Current meta-analysis suggested the association of some elements of neuropathy with SAS in type 2 diabetes. Further investigations are needed to clarify whether the association is also true for patients with type 1 diabetes.