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不同治疗方法的阻塞性睡眠呼吸暂停患者糖尿病风险的对比分析。

Comparative analysis of diabetes risk in patients with obstructive sleep apnea undergoing different treatment approaches.

机构信息

Department of Family Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan, ROC.

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.

出版信息

J Otolaryngol Head Neck Surg. 2023 Aug 11;52(1):51. doi: 10.1186/s40463-023-00651-8.

DOI:10.1186/s40463-023-00651-8
PMID:37568170
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10416494/
Abstract

The bidirectional relationship between obstructive sleep apnea (OSA) and diabetes mellitus (DM) has been explored in several studies. O'Connor-Reina et al., published a paper entitled: "Risk of diabetes in patients with sleep apnea: comparison of surgery versus CPAP in a long-term follow-up study" to examine a cohort study comparing the effects of surgery and continuous positive airway pressure (CPAP) on the risk of diabetes in patients with OSA. The study findings suggest that both therapies offer protection against diabetes, with upper airway surgery demonstrating better preventive efficacy than CPAP. However, potential biases and confounding variables should be considered, such as race, ethnicity, socioeconomic factors, BMI, glucose levels, HbA1c values, medication use and healthy dietary habits. Besides using International Classification of Diseases codes, the definition of DM as an outcome can also incorporate specific laboratory indicators and the use of diabetes treatment medications. Furthermore, subgroups analysis defined by demographic variables, such as age, sex, and race is recommended. The limitations of the study also include potentially data omissions due to reliance on electronic medical records from specific healthcare institutions. To enhance research comprehensiveness, alternative data sources and collaborations with additional healthcare institutions are suggested for future investigations.

摘要

阻塞性睡眠呼吸暂停(OSA)与糖尿病(DM)之间的双向关系已在多项研究中得到探讨。O'Connor-Reina 等人发表了一篇题为“睡眠呼吸暂停患者患糖尿病的风险:手术与 CPAP 在长期随访研究中的比较”的论文,旨在研究一项比较手术和持续气道正压通气(CPAP)对 OSA 患者糖尿病风险影响的队列研究。研究结果表明,两种治疗方法都能预防糖尿病,上呼吸道手术的预防效果优于 CPAP。然而,应该考虑潜在的偏倚和混杂变量,如种族、民族、社会经济因素、BMI、血糖水平、HbA1c 值、药物使用和健康的饮食习惯。除了使用国际疾病分类代码外,DM 的定义也可以包含特定的实验室指标和糖尿病治疗药物的使用。此外,建议根据年龄、性别和种族等人口统计学变量进行亚组分析。该研究的局限性还包括由于依赖特定医疗机构的电子病历,可能存在数据缺失。为了增强研究的全面性,建议未来的研究使用替代数据来源并与其他医疗机构合作。

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本文引用的文献

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Risk of diabetes in patients with sleep apnea: comparison of surgery versus CPAP in a long-term follow-up study.睡眠呼吸暂停患者的糖尿病风险:长期随访研究中手术与 CPAP 的比较。
J Otolaryngol Head Neck Surg. 2023 Feb 14;52(1):16. doi: 10.1186/s40463-022-00616-3.
2
Gender Differences in the Association Between Obstructive Sleep Apnea and Diabetes.阻塞性睡眠呼吸暂停与糖尿病之间关联的性别差异。
Diabetes Metab Syndr Obes. 2021 Nov 23;14:4589-4597. doi: 10.2147/DMSO.S326425. eCollection 2021.
3
African ethnicity is associated with a higher prevalence of diabetes in obstructive sleep apnea patients: results of a retrospective analysis.非洲裔与阻塞性睡眠呼吸暂停患者中较高的糖尿病患病率相关:一项回顾性分析结果
Sleep Breath. 2020 Sep;24(3):857-864. doi: 10.1007/s11325-019-01912-5. Epub 2019 Aug 14.
4
Obstructive sleep apnea as a risk factor for type 2 diabetes mellitus.阻塞性睡眠呼吸暂停作为2型糖尿病的一个危险因素。
Nat Sci Sleep. 2015 Oct 5;7:113-25. doi: 10.2147/NSS.S90835. eCollection 2015.