Association of sleep apnea and type II diabetes - A population-based study
Association of sleep apnea and type II diabetes - A population-based study
复制标题
DOI：
10.1164/rccm.200504-637oc
复制
发表时间：
2005-12-15
影响因子：
24.7
通讯作者：
Young, T
中科院分区：
文献类型：
--
作者：
Reichmuth, KJ;Austin, D;Young, T
理由：睡眠呼吸障碍（SDB）与胰岛素抵抗之间的横断面关联已被报道，但尚未进行前瞻性研究以确定SDB是否与糖尿病的发展有关。目的：本研究旨在探讨SDB患者11型糖尿病的患病率和发病率，以及两者之间是否存在独立关系。方法：对威斯康星睡眠队列的1387名参与者进行了横断面和纵向分析。全多导睡眠描记术用于SDB的表征。糖尿病的定义有两种方式：(1)医生单独诊断；(2)有血糖测量的患者，空腹血糖>= 126 mg/dl或医生诊断。测量结果和主要结果：随着SDB水平的升高，糖尿病的患病率增加。在呼吸暂停低通气指数（AHI）为15或更高的受试者中，有14.7%的人被诊断为糖尿病，而AHI低于5的受试者中这一比例为2.8%。在调整了年龄、性别和体质因素后，AHI≥15与AHI小于5被医生诊断为糖尿病的比值比为2.30（95%可信区间1.28-4.11;p = 0.005）。在调整年龄、性别和身体习惯后，4年内AHI≥15与AHI小于5发生糖尿病的比值比为1.62（95%可信区间，0.67-3.65;p = 0.24）。结论：糖尿病在SDB中发病率更高，且与其他危险因素无关。然而，目前尚不清楚SDB是否导致糖尿病的发生。
Rationale: Cross-sectional association has been reported between sleep-disordered breathing (SDB) and insulin resistance, but no prospective studies have been performed to determine whether SDB is causal in the development of diabetes.Objectives: The purpose of our study was to investigate the prevalence and incidence of type 11 diabetes in subjects with SDB and whether an independent relationship exists between them.Methods: A cross-sectional and longitudinal analysis was performed in 1,387 participants of the Wisconsin Sleep Cohort. Full polysomnography was used to characterize SDB. Diabetes was defined in two ways: (1) physician-diagnosis alone or (2) for those with glucose measurements, either fasting glucose >= 126 mg/dl or physician diagnosis.Measurements and Main Results: There was a greater prevalence of diabetes in subjects with increasing levels of SDB. A total of 14.7% of subjects with an apnea-hypopnea index (AHI) of 15 or more had a diagnosis of diabetes compared with 2.8% of subjects with an AHI of less than 5. The odds ratio for having a physician diagnoses of diabetes mellitus with an AHI of 15 or greater versus an AHI of less than 5 was 2.30 (95% confidence interval, 1.28-4.11; p = 0.005) after adjustment for age, sex, and body habitus. The odds ratio for developing diabetes mellitus within 4 yr with an AHI of 15 or more compared with an AHI of less than 5 was 1.62 (95% confidence interval, 0.67-3.65; p = 0.24) when adjusting for age, sex, and body habitus.Conclusions: Diabetes is more prevalent in SDB and this relationship is independent of other risk factors. However, it is not clear that SDB is causal in the development of diabetes.