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夜间氧饱和度参数作为阻塞性睡眠呼吸暂停患者2型糖尿病的独立危险因素

Nocturnal Oxygen Saturation Parameters as Independent Risk Factors for Type 2 Diabetes Mellitus among Obstructive Sleep Apnea Patients.

作者信息

Gabryelska Agata, Chrzanowski Jędrzej, Sochal Marcin, Kaczmarski Piotr, Turkiewicz Szymon, Ditmer Marta, Karuga Filip Franciszek, Czupryniak Leszek, Białasiewicz Piotr

机构信息

Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland.

Department of Biostatistics and Translational Medicine, Medical University of Lodz, 92-215 Lodz, Poland.

出版信息

J Clin Med. 2021 Aug 24;10(17):3770. doi: 10.3390/jcm10173770.

Abstract

Obstructive sleep apnea (OSA) is a recognized independent risk factor for metabolic disorders, type 2 diabetes mellites (DM2) in particular. Therefore, the study aimed to assess the influence of nocturnal oxygen saturation parameters on the onset of DM2 among OSA patients. The study consisted of 549 participants, who underwent polysomnography examination. Based on apnea hypopnea index (AHI), 465 patients were diagnosed with OSA. One hundred and seven individuals had comorbid DM2. Cox regression models were used to assess the effect of oxygen saturation parameters on the onset of DM2. Classification and regression trees (CART) analysis was used to assess the onset of the DM2 in the study group in context of oxygen saturation variables. One-way Cox regression showed higher risk of earlier DM2 for increased values of BMI, AHI, decreased basal O and O nadir value, while lowered mean O desaturation has not shown statistical significance. In the CART analysis, the following cut-off points 92.2%, 81.7%, 87.1% were determined for basal O, O nadir and mean O desaturation, respectively, with the first two parameters being statistically significant. Therefore, basal O is independent from AHI, BMI and age is a risk factor of DM2 among OSA patients.

摘要

阻塞性睡眠呼吸暂停(OSA)是一种公认的代谢紊乱独立危险因素,尤其是2型糖尿病(DM2)。因此,本研究旨在评估夜间血氧饱和度参数对OSA患者发生DM2的影响。该研究包括549名参与者,他们接受了多导睡眠图检查。根据呼吸暂停低通气指数(AHI),465例患者被诊断为OSA。107例个体合并DM2。采用Cox回归模型评估血氧饱和度参数对DM2发病的影响。使用分类与回归树(CART)分析在血氧饱和度变量背景下评估研究组中DM2的发病情况。单因素Cox回归显示,BMI、AHI值升高,基础氧和氧最低点值降低会增加DM2早期发病风险,而平均氧去饱和降低未显示统计学意义。在CART分析中,分别确定基础氧、氧最低点和平均氧去饱和的截断点为92.2%、81.7%、87.1%,前两个参数具有统计学意义。因此,基础氧独立于AHI、BMI,年龄是OSA患者发生DM2的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47a0/8432118/673cc4ce68aa/jcm-10-03770-g001.jpg

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