Lu Na, Yin Fuzai
Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 May 23;16:1505-1513. doi: 10.2147/DMSO.S408637. eCollection 2023.
This study aimed to propose the hyperuricemia-waist (HUAW) phenotype and investigate the relationship between the HUAW phenotype and obstructive sleep apnea (OSA) in type 2 diabetes mellitus (T2DM).
We enrolled 255 patients with T2DM (165 male and 90 female) from the First Hospital of Qinhuangdao. The sleep test was performed, and serum uric acid (UA) levels and waist circumference (WC) were calculated. The HUAW phenotype was defined as serum UA concentrations ≥420 μmol/L and WC ≥90 cm (male) and ≥85 cm (female). The participants were categorized into four phenotype groups based on the mentioned cutoffs: normal WC and normal UA concentrations (group A); normal WC and elevated UA concentrations (group B); enlarged WC and normal UA concentrations (group C); and enlarged WC and elevated UA concentrations (group D). Among these participants, 17.6% were characterized by the HUAW phenotype, 80.0% had OSA, and 47.0% had moderate-to-severe OSA. The prevalence of OSA was 43.4%, 71.4%, 89.7%, and 97.8% in groups A, B, C, and D, respectively. The prevalence of moderate-to-severe OSA was 7.5%, 28.6%, 56.9%, and 72.7% in groups A, B, C, and D, respectively. After adjusting for age, sex, duration of diabetes, glycosylated hemoglobin A1c, smoking, and drinking, the HUAW phenotype was found to be significantly associated with OSA and moderate-to-severe OSA.
The present study proposed the HUAW phenotype and demonstrated that in T2DM, the HUAW phenotype was associated with OSA, especially with moderate-to-severe OSA. Unlike T2DM without the HUAW phenotype, T2DM with the HUAW phenotype showed a significantly higher prevalence of OSA, especially moderate-to-severe OSA. Thus, early sleep studies should be routinely examined in individuals with T2DM who display the HUAW phenotype.
本研究旨在提出高尿酸血症-腰围（HUAW）表型，并探讨2型糖尿病（T2DM）患者中HUAW表型与阻塞性睡眠呼吸暂停（OSA）之间的关系。
我们纳入了秦皇岛市第一医院的255例T2DM患者（男性165例，女性90例）。进行睡眠测试，并计算血清尿酸（UA）水平和腰围（WC）。HUAW表型定义为血清UA浓度≥420μmol/L且WC≥90cm（男性）和≥85cm（女性）。根据上述临界值，将参与者分为四个表型组：WC正常且UA浓度正常（A组）；WC正常且UA浓度升高（B组）；WC增大且UA浓度正常（C组）；WC增大且UA浓度升高（D组）。在这些参与者中，17.6%具有HUAW表型，80.0%患有OSA，47.0%患有中重度OSA。A、B、C、D组中OSA的患病率分别为43.4%、71.4%、89.7%和97.8%。A、B、C、D组中重度OSA的患病率分别为7.5%、28.6%、56.9%和72.7%。在调整年龄、性别、糖尿病病程、糖化血红蛋白A1c、吸烟和饮酒因素后，发现HUAW表型与OSA及中重度OSA显著相关。
本研究提出了HUAW表型，并证明在T2DM患者中，HUAW表型与OSA相关，尤其是与中重度OSA相关。与无HUAW表型的T2DM患者不同，有HUAW表型的T2DM患者OSA的患病率显著更高，尤其是中重度OSA。因此，对于表现出HUAW表型的T2DM患者，应常规进行早期睡眠研究检查。
