Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand.
Department of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, Thailand.
Diabetes Metab Syndr. 2020 Nov-Dec;14(6):1859-1863. doi: 10.1016/j.dsx.2020.09.008. Epub 2020 Sep 10.
Obstructive sleep apnea (OSA) is known to be associated with diabetes mellitus (DM). Age is factor associated with different clinical features of OSA. There is limited data on clinical differences of young DM patients with OSA versus older DM patients with OSA. This study aimed to find clinical differences of DM coexisting with OSA between young age group and older.
This is a retrospective, analytical study conducted at Srinagarind Hospital, Thailand. The inclusion criteria were adult patients diagnosed as DM with OSA. The study period was between January 2008 and December 2019. The diagnosis of OSA was made by presence of apnea hypopnea index (AHI) of ≥5 times/hour by polysomnography. Clinical predictors of OSA in young DM patients with age under 40 years were executed.
There were 56 patients in the young diabetes mellitus group, while there were 137 patients in the older diabetes mellitus group. The mean (SD) age of diagnosis for diabetes mellitus of both groups were 31.61 (6.53) and 54.68 (7.62) years, respectively. There were three independent predictors for DM in the young: atrial fibrillation (AF), body mass index (BMI) and glomerular filtration rate (GFR). Presence of AF perfectly predicted DM with OSA in age over 40 years. The adjusted odds ratio for BMI and GFR were 1.29 (95% CI 1.05, 1.58) and 1.06 (1.01, 1.13). The BMI over 32 kg/m and GFR over 77 ml/min/m gave sensitivity of 80.00%.
Young DM patients with OSA had more severe OSA, were more obese, had better renal function, and had fewer AF than the older ones.
阻塞性睡眠呼吸暂停（OSA）与糖尿病（DM）有关。年龄是与 OSA 不同临床特征相关的因素。关于年轻 DM 患者与老年 DM 患者 OSA 的临床差异，数据有限。本研究旨在发现年轻和老年 DM 患者并发 OSA 的临床差异。
这是一项在泰国诗里叻医院进行的回顾性分析研究。纳入标准为被诊断为 OSA 的成年 DM 患者。研究期间为 2008 年 1 月至 2019 年 12 月。通过多导睡眠图检查，将 AHI 大于或等于 5 次/小时作为 OSA 的诊断标准。对年龄小于 40 岁的年轻 DM 患者并发 OSA 的临床预测因素进行分析。
年轻糖尿病组有 56 例，老年糖尿病组有 137 例。两组糖尿病诊断的平均（SD）年龄分别为 31.61（6.53）岁和 54.68（7.62）岁。年轻组有三个独立的 DM 预测因素：心房颤动（AF）、体重指数（BMI）和肾小球滤过率（GFR）。AF 的存在可以完美预测年龄超过 40 岁的患者并发 DM。BMI 和 GFR 的调整后比值比分别为 1.29（95%CI 1.05，1.58）和 1.06（1.01，1.13）。BMI 超过 32kg/m 和 GFR 超过 77ml/min/m 时，敏感性为 80.00%。
与老年 DM 患者相比，年轻 DM 患者 OSA 更严重、肥胖程度更高、肾功能更好、AF 更少。
