Sánchez Enric, Sapiña-Beltrán Esther, Gavaldà Ricard, Barbé Ferran, Torres Gerard, Sauret Ariadna, Dalmases Mireia, López-Cano Carolina, Gutiérrez-Carrasquilla Liliana, Bermúdez-López Marcelino, Fernández Elvira, Purroy Francisco, Castro-Boqué Eva, Farràs-Sallés Cristina, Pamplona Reinald, Mauricio Dídac, Hernández Cristina, Simó Rafael, Lecube Albert
Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, 25198 Lleida, Spain.
Obesity, Diabetes and Metabolism (ODIM) Research Group, Institut de Recerca Biomèdica de Lleida (IRBLleida), 25198 Lleida, Spain.
J Clin Med. 2022 Mar 4;11(5):1413. doi: 10.3390/jcm11051413.
Type 2 diabetes leads to severe nocturnal hypoxemia, with an increase in apnea events and daytime sleepiness. Hence, we assessed sleep breathing parameters in the prediabetes stage. A cross-sectional study conducted on 966 middle-aged subjects without known pulmonary disease (311 patients with prediabetes and 655 controls with normal glucose metabolism) was conducted. Prediabetes was defined by glycated hemoglobin (HbA1c), and a nonattended overnight home sleep study was performed. Participants with prediabetes (n = 311) displayed a higher apnea−hypopnea index (AHI: 12.7 (6.1;24.3) vs. 9.5 (4.2;19.6) events/h, p < 0.001) and hypopnea index (HI: 8.4 (4.0;14.9) vs. 6.0 (2.7;12.6) events/h, p < 0.001) than controls, without differences in the apnea index. Altogether, the prevalence of obstructive sleep apnea was higher in subjects with prediabetes than in controls (78.1 vs. 69.9%, p = 0.007). Additionally, subjects with prediabetes presented impaired measurements of the median and minimum nocturnal oxygen saturation, the percentage of time spent with oxygen saturations below 90%, and the 4% oxygen desaturation index in comparison with individuals without prediabetes (p < 0.001 for all). After adjusting for age, sex, and the presence of obesity, HbA1c correlated with the HI in the entire population (r = 0.141, p < 0.001), and the presence of prediabetes was independently associated with the AHI (B = 2.20 (0.10 to 4.31), p = 0.040) as well as the HI (B = 1.87 (0.61 to 3.14), p = 0.004) in the multiple linear regression model. We conclude that prediabetes is an independent risk factor for an increased AHI after adjusting for age, sex, and obesity. The enhanced AHI is mainly associated with increments in the hypopnea events.
2型糖尿病会导致严重的夜间低氧血症，呼吸暂停事件增加以及日间嗜睡。因此，我们评估了糖尿病前期阶段的睡眠呼吸参数。对966名无已知肺部疾病的中年受试者（311名糖尿病前期患者和655名葡萄糖代谢正常的对照者）进行了一项横断面研究。通过糖化血红蛋白（HbA1c）定义糖尿病前期，并进行了无人值守的夜间家庭睡眠研究。糖尿病前期参与者（n = 311）的呼吸暂停低通气指数（AHI：12.7（6.1；24.3）次/小时 vs. 9.5（4.2；19.6）次/小时，p < 0.001）和低通气指数（HI：8.4（4.0；14.9）次/小时 vs. 6.0（2.7；12.6）次/小时，p < 0.001）高于对照组，呼吸暂停指数无差异。总体而言，糖尿病前期受试者中阻塞性睡眠呼吸暂停的患病率高于对照组（78.1% vs. 69.9%，p = 0.007）。此外，与无糖尿病前期的个体相比，糖尿病前期受试者的夜间氧饱和度中位数和最低值、氧饱和度低于90%的时间百分比以及4%氧去饱和指数的测量值均受损（所有p < 0.001）。在调整年龄、性别和肥胖因素后，HbA1c与整个人群的HI相关（r = 0.141，p < 0.001），在多元线性回归模型中，糖尿病前期的存在与AHI（B = 2.20（0.10至4.31），p = 由于年龄、性别和肥胖因素后，糖尿病前期是AHI增加的独立危险因素。AHI升高主要与低通气事件增加有关。 （注：原文最后一句“p = 0.040”在翻译中位置有误，应紧跟“B = 2.20 (0.1
