Hein Matthieu, Lanquart Jean-Pol, Mungo Anais, Loas Gwenolé
Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB - Anderlecht - Bruxelles - Belgium.
Sleep Sci. 2022 Jan-Mar;15(Spec 1):184-194. doi: 10.5935/1984-0063.20220018.
In the general population, co-morbid insomnia and sleep apnoea (COMISA) is associated with higher risk of cardiovascular diseases (CVD). However, despite a high prevalence of COMISA in type 2 diabetics, no study has investigated its potential implication in the negative cardiovascular outcome of this particular subpopulation. The aim of this study was therefore to examine the risk of CVD associated with COMISA in type 2 diabetics.
Data from 471 type 2 diabetics recruited from the clinical database of the Erasme Hospital sleep laboratory were analysed. Only type 2 diabetics with SCORE index ≥5% were included in the group at high risk of CVD. Logistic regression analyses were conducted to examine the risk of CVD associated with COMISA in type 2 diabetics.
A high risk of CVD was present in 32.9% of type 2 diabetics. After adjustment for the main confounding factors associated with cardiovascular risk, multivariate logistic regression analysis revealed that unlike obstructive sleep apnoea syndrome or insomnia alone, only COMISA was associated with higher risk of CVD in type 2 diabetics.
In our study, we have demonstrated that unlike its components alone, only COMISA was associated with higher risk of CVD in type 2 diabetics, which highlights the importance of the central role played by the negative synergistic effect of COMISA on the cardiovascular outcome in this particular subpopulation. Thus, given these elements, more systematic research and adequate therapeutic management of COMISA seem to be necessary to allow better cardiovascular prevention in type 2 diabetics.
在普通人群中，共病性失眠与睡眠呼吸暂停（COMISA）与心血管疾病（CVD）风险较高相关。然而，尽管2型糖尿病患者中COMISA的患病率很高，但尚无研究调查其在这一特定亚人群不良心血管结局中的潜在影响。因此，本研究的目的是探讨2型糖尿病患者中与COMISA相关的CVD风险。
对从伊拉斯谟医院睡眠实验室临床数据库招募的471例2型糖尿病患者的数据进行分析。只有SCORE指数≥5%的2型糖尿病患者被纳入CVD高风险组。进行逻辑回归分析以研究2型糖尿病患者中与COMISA相关的CVD风险。
32.9%的2型糖尿病患者存在CVD高风险。在对与心血管风险相关的主要混杂因素进行调整后，多变量逻辑回归分析显示，与单纯阻塞性睡眠呼吸暂停综合征或失眠不同，只有COMISA与2型糖尿病患者较高的CVD风险相关。
在我们的研究中，我们已经证明，与单独的组成部分不同，只有COMISA与2型糖尿病患者较高的CVD风险相关，这突出了COMISA的负面协同作用在这一特定亚人群心血管结局中所起的核心作用的重要性。因此，鉴于这些因素，似乎有必要对COMISA进行更系统的研究和适当的治疗管理，以便在2型糖尿病患者中更好地预防心血管疾病。
