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阻塞性睡眠呼吸暂停与糖尿病之间关联的性别差异。

Gender Differences in the Association Between Obstructive Sleep Apnea and Diabetes.

作者信息

Tao Ye, Li Xiaoli, Yang Guang, Wang Lingling, Lian Junsong, Chang Zheng

机构信息

Central Medical District of Chinese PLA General Hospital, Beijing, People's Republic of China.

The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2021 Nov 23;14:4589-4597. doi: 10.2147/DMSO.S326425. eCollection 2021.

DOI:10.2147/DMSO.S326425
PMID:34848983
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8627197/
Abstract

OBJECTIVE

This study aimed to explore the association between obstructive sleep apnea (OSA) and diabetes in a Chinese population based on a cross-sectional analysis of patient data from a large tertiary care hospital in China and analyses whether there are any gender differences in this association.

METHODS

A total of 794 (615 men and 179 women) inpatients were involved in this study. Polysomnography (PSG) was used to diagnose OSA, and overnight PSG testing was performed on each subject included in this study. All study subjects were also diagnosed with whether they had diabetes by an endocrinologist in the hospital.

RESULTS

After adjusting for sex, age, smoking status, alcohol consumption and body mass index (BMI) groups, the results showed that the number of apnea-hypopnea index (AHI) events was a risk factor for diabetes, with a 9% (95% CI: 1-17%) increase in the risk of diabetes per unit increase, while subjects with higher (per unit increase) lowest oxygen saturation value monitored during the subject's sleep (LSaO) with a 13% (95% CI: 4-22%) decrease in the risk of diabetes. Stratified analyses by gender, after adjustment, in men, OSA and its associated monitoring indicators were statistically significantly associated with diabetes [OR for severe OSA was 2.269 (95% CI: 1.164, 4.425), P=0.016, and OR for severe hypoxemia was 2.228 (95% CI: 1.145, 4.334), P=0.018], while not in women.

CONCLUSION

Our study found a significant association between OSA and diabetes in a Chinese clinical-based population as well as a dose-response relationship between the severity of AHI and severe hypoxemia (LSaO < 80%) and blood glucose, the association has gender difference and was only present significant association in men, which demonstrated that diabetes prevention and blood glucose screening and management should be enhanced for Chinese men with OSA.

摘要

目的

本研究旨在基于对中国一家大型三级医院患者数据的横断面分析,探讨中国人群中阻塞性睡眠呼吸暂停(OSA)与糖尿病之间的关联,并分析这种关联是否存在性别差异。

方法

本研究共纳入794名住院患者(615名男性和179名女性)。采用多导睡眠图(PSG)诊断OSA,并对本研究纳入的每个受试者进行整夜PSG检测。所有研究受试者还由医院的内分泌科医生诊断是否患有糖尿病。

结果

在调整性别、年龄、吸烟状况、饮酒情况和体重指数(BMI)分组后,结果显示呼吸暂停低通气指数(AHI)事件数量是糖尿病的一个危险因素,每单位增加糖尿病风险增加9%(95%CI:1-17%),而在受试者睡眠期间监测到的最低氧饱和度值(LSaO)较高(每单位增加)的受试者糖尿病风险降低13%(95%CI:4-22%)。按性别进行分层分析,调整后,在男性中,OSA及其相关监测指标与糖尿病在统计学上显著相关[重度OSA的OR为2.269(95%CI:1.164,4.425),P=0.016,重度低氧血症的OR为2.228(95%CI:1.145,4.334),P=0.018],而在女性中则不然。

结论

我们的研究发现,在中国以临床为基础的人群中,OSA与糖尿病之间存在显著关联,以及AHI严重程度和重度低氧血症(LSaO<80%)与血糖之间存在剂量反应关系,这种关联存在性别差异,且仅在男性中存在显著关联,这表明对于患有OSA的中国男性应加强糖尿病预防以及血糖筛查和管理。