Service de pneumologie, Hôtel-Dieu de Paris, université Paris-Descartes, AP-HP, Paris, France.
Diabetes Metab. 2009 Nov;35(5):372-7. doi: 10.1016/j.diabet.2009.03.007. Epub 2009 Aug 15.
This study aimed to assess the prevalence and characteristics of sleep apnoea syndrome (SAS) in patients hospitalized for poorly controlled type 2 diabetes.
An overnight ventilatory polygraphic study was systematically performed in 303 consecutive patients.
Overall, 34% of these patients had mild SAS, as defined by a respiratory disturbance index (RDI) of 5-15; 19% had moderate SAS (RDI: 16-29) and 10% had severe SAS (RDI>or=30). The SAS was obstructive in 99% of the apnoeic patients. The percentage of patients with excessive daytime sleepiness (Epworth sleepiness scale>10), fatigue or nocturia did not significantly differ among patients with severe, moderate or mild SAS versus non-apnoeic patients. The percentage of patients who snored was significantly higher in patients with severe or moderate SAS versus non-apnoeic patients. HbA(1c), duration of diabetes and the prevalences of microalbuminuria, retinopathy and peripheral neuropathy did not significantly differ among patients with severe, moderate or mild SAS versus non-apnoeic patients. However, patients with severe or moderate SAS had significantly higher values for body mass index, waist circumference and neck circumference than non-apnoeic patients.
In type 2 diabetic patients with poor diabetic control, obstructive SAS is highly prevalent and related to abdominal obesity, and should be systematically screened for, as it cannot be predicted by the clinical data.
本研究旨在评估因 2 型糖尿病控制不佳而住院的患者中睡眠呼吸暂停综合征(SAS)的患病率和特征。
对 303 例连续患者进行了整夜通气多导睡眠图研究。
这些患者中,34%的患者患有轻度 SAS,定义为呼吸紊乱指数(RDI)为 5-15;19%的患者患有中度 SAS(RDI:16-29),10%的患者患有重度 SAS(RDI>或=30)。SAS 在 99%的呼吸暂停患者中为阻塞性。在日间嗜睡(Epworth 嗜睡量表>10)、疲劳或夜尿症的患者百分比方面,严重、中度或轻度 SAS 患者与非呼吸暂停患者之间没有显著差异。在严重或中度 SAS 患者中,打鼾的患者百分比明显高于非呼吸暂停患者。HbA(1c)、糖尿病病程以及微量白蛋白尿、视网膜病变和周围神经病变的患病率在严重、中度或轻度 SAS 患者与非呼吸暂停患者之间没有显著差异。然而,严重或中度 SAS 患者的体重指数、腰围和颈围明显高于非呼吸暂停患者。
在糖尿病控制不佳的 2 型糖尿病患者中,阻塞性 SAS 非常普遍,与腹部肥胖有关,应系统筛查,因为其不能通过临床数据预测。