Tan Cui-Xia, Gao Yun, Wang Chun, Li Yan, Feng Xiao-Bing, Cheng Yang-Fan, Zhang Yang, Ran Xing-Wu
Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Endocrinology, the First People's Hospital of Chengdu, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2017 May;48(3):441-445.
To compare the clinical characteristics and prevalence of chronic complications in type 2 diabetes mellitus (T2DM) patients with various degrees of obstructive sleep apnea syndrome (OSAS).
A total of 170 patients with T2DM and OSAS were enrolled in this study. These participants were divided into three groups with low, medium and high apnea-hypopnea index (AHI), respectively. The demographic characteristics, biochemical indicators and chronic complications of the patients in the three groups were compared. Multivariate Logistic regression analysis was performed to determine the associations between chronic complications and OSAS.
The patients with severe OSAS had higher waist circumference (=0.045), higher BMI (=0.069), higher prevalence of diabetic peripheral neuropathy (DPN), and higher prevalence of diabetic retinopathy (DR) than the patients with mild-moderate OSAS. Similar levels of macrovascular complications were found in the three groups (>0.05). The logistic regression analyses showed that DPN (=1.024, 95% 1.002-1.046) and chronic kidney disease (=1.026, 95% 1.004-1.049) were independent predictors of AHI, adjusting for the lowest oxygen saturation, gender, age, diabetic duration, family history of diabetes, BMI, and HbA1c. Other microvascular and macrovascular complications were not predictors of AHI.
Patients with T2DM and severe OSAS have a higher risk of DPN and DR. Particular attention should be paid to T2DM patients with severe OSAS to prevent complications.
比较不同程度阻塞性睡眠呼吸暂停低通气综合征（OSAS）的2型糖尿病（T2DM）患者的临床特征及慢性并发症患病率。
本研究共纳入170例T2DM合并OSAS患者。这些参与者分别被分为低、中、高呼吸暂停低通气指数（AHI）三组。比较三组患者的人口统计学特征、生化指标及慢性并发症情况。进行多因素Logistic回归分析以确定慢性并发症与OSAS之间的关联。
与轻中度OSAS患者相比，重度OSAS患者的腰围更高（=0.045）、体重指数更高（=0.069）、糖尿病周围神经病变（DPN）患病率更高，糖尿病视网膜病变（DR）患病率也更高。三组的大血管并发症水平相似（>0.05）。Logistic回归分析显示，校正最低血氧饱和度、性别、年龄、糖尿病病程、糖尿病家族史、体重指数和糖化血红蛋白后，DPN（=1.024，95% 1.002 - 1.046）和慢性肾脏病（=1.026，95% 1.004 - 1.049）是AHI的独立预测因素。其他微血管和大血管并发症不是AHI的预测因素。
T2DM合并重度OSAS患者发生DPN和DR的风险更高。应特别关注T2DM合并重度OSAS患者以预防并发症。
