Nagayoshi Mako, Punjabi Naresh M, Selvin Elizabeth, Pankow James S, Shahar Eyal, Iso Hiroyasu, Folsom Aaron R, Lutsey Pamela L
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA; Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sleep Med. 2016 Sep;25:156-161. doi: 10.1016/j.sleep.2016.05.009. Epub 2016 Sep 29.
To determine whether severity of obstructive sleep apnea is associated with incident diabetes in middle-aged and older adults.
A prospective analysis of 1453 non-diabetic participants of both the Atherosclerosis Risk in Communities Study and the Sleep Heart Health Study (mean age 63 years, 46% male) had in-home polysomnography (1996-1998) and was followed up for incident diabetes. Using the apnea-hypopnea index derived from home polysomnography, study participants were categorized as follows: <5.0 (normal), 5.0-14.9 (mild), 15.0-29.9 (moderate), and ≥30.0 events/h (severe). Incident diabetes was ascertained during annual follow-up telephone calls through 2013.
During a median follow-up of 13 years, there were 285 incident diabetes cases among the 1453 participants. Participants with severe obstructive sleep apnea were at greater risk of incident diabetes compared to persons classified as normal after adjustment for confounders including body mass index and waist circumference (1.71 [1.08, 2.71]). The association between severe obstructive sleep apnea and incident diabetes was similar when analyses were restricted to obese individuals.
Severe obstructive sleep apnea was associated with greater risk of incident diabetes, independent of adiposity in a community-based sample. Healthcare professionals should be cognizant of the high prevalence of OSA in the general population and the potential link to incident diabetes.
确定中老年人群中阻塞性睡眠呼吸暂停的严重程度与糖尿病发病是否相关。
对社区动脉粥样硬化风险研究和睡眠心脏健康研究中的1453名非糖尿病参与者（平均年龄63岁，46%为男性）进行前瞻性分析，这些参与者于1996 - 1998年在家中进行了多导睡眠监测，并随访糖尿病发病情况。根据家庭多导睡眠监测得出的呼吸暂停低通气指数，将研究参与者分为以下几类：<5.0（正常）、5.0 - 14.9（轻度）、15.0 - 29.9（中度）和≥30.0次/小时（重度）。通过2013年的年度随访电话确定糖尿病发病情况。
在13年的中位随访期内，1453名参与者中有285例糖尿病发病。在对包括体重指数和腰围等混杂因素进行调整后，与被分类为正常的人相比，重度阻塞性睡眠呼吸暂停的参与者患糖尿病的风险更高（1.71 [1.08, 2.71]）。当分析仅限于肥胖个体时，重度阻塞性睡眠呼吸暂停与糖尿病发病之间的关联相似。
在基于社区的样本中，重度阻塞性睡眠呼吸暂停与糖尿病发病风险增加相关，且独立于肥胖因素。医疗保健专业人员应认识到普通人群中阻塞性睡眠呼吸暂停的高患病率以及与糖尿病发病的潜在联系。
