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阻塞性睡眠呼吸暂停综合征与1型/2型糖尿病之间的关联:一项系统评价和荟萃分析。

Association between obstructive sleep apnea syndrome and type1/type2 diabetes mellitus: A systematic review and meta-analysis.

作者信息

Huang Huiling, Chen Zhang

机构信息

Department General Medicine, Shenzhen Luohu Hospital Group Luohu People's Hospital, Shenzhen, Guangdong Province, China.

Department General Medicine, Luohu Clinical College of Shantou University Medical College, Shenzhen, Guangdong Province, China.

出版信息

J Diabetes Investig. 2025 Mar;16(3):521-534. doi: 10.1111/jdi.14354. Epub 2024 Dec 20.

Abstract

INTRODUCTION

Obstructive sleep apnea (OSA) is characterized by a complete or partial obstruction of the upper airway, along with hypoxemia, microarousals, and sleep fragmentation. Compelling evidence has clarified a bidirectional correlation between OSA and diabetes mellitus (DM). This paper was to assess the link between OSA and DM via meta-analysis, consisting of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS

Four databases (PubMed, Cochrane Library, Embase, and CNKI) were screened from inception to March 2024 for observational studies of OSA and DM, including case-control studies and cohort studies. Bidirectional associations between OSA and DM were analyzed, consisting of T1DM and T2DM. Random-effect models were employed to determine the pooled odds ratio (OR) and 95% confidence intervals (CIs) to compare prevalence. Traditional subgroup analyses were implemented. Review Manager 5.3 and Stata 16.0 were utilized for data analyses.

RESULTS

Thirty-five studies were enrolled, including 12 prospective cohort studies, 4 retrospective cohort studies, and 19 case-control studies. DM prevalence was notably higher in OSA patients than in non-OSA patients (OR: 2.29, 95% CI: 1.93-2.72), and OSA prevalence was notably higher in DM patients than in non-DM patients (OR: 2.12, 95% CI: 1.73-2.60). Subgroup analysis uncovered that DM prevalence in the OSA population was more significant in the group <50 years (OR: 3.28, 95% CI: 2.20-4.89) and slightly decreased in the group >50 years (OR: 1.82, 95% CI: 1.38-2.40).

CONCLUSIONS

The meta-analysis reveals a bidirectional link between OSA and DM.

摘要

引言

阻塞性睡眠呼吸暂停(OSA)的特征是上呼吸道完全或部分阻塞,同时伴有低氧血症、微觉醒和睡眠片段化。有力证据表明OSA与糖尿病(DM)之间存在双向关联。本文旨在通过荟萃分析评估OSA与DM之间的联系,其中包括1型糖尿病(T1DM)和2型糖尿病(T2DM)。

材料与方法

检索了四个数据库(PubMed、Cochrane图书馆、Embase和中国知网),从建库至2024年3月,查找关于OSA与DM的观察性研究,包括病例对照研究和队列研究。分析了OSA与DM之间的双向关联,包括T1DM和T2DM。采用随机效应模型确定合并比值比(OR)和95%置信区间(CIs)以比较患病率。进行了传统亚组分析。使用Review Manager 5.3和Stata 16.0进行数据分析。

结果

纳入了35项研究,包括12项前瞻性队列研究、4项回顾性队列研究和19项病例对照研究。OSA患者的DM患病率显著高于非OSA患者(OR:2.29,95% CI:1.93 - 2.72),DM患者的OSA患病率显著高于非DM患者(OR:2.12,95% CI:1.73 - 2.60)。亚组分析发现,OSA人群中DM患病率在<50岁组更为显著(OR:3.28,95% CI:2.20 - 4.89),在>50岁组略有下降(OR:1.82,95% CI:1.38 - 2.40)。

结论

荟萃分析揭示了OSA与DM之间的双向联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/597f/11871397/1f71c7358838/JDI-16-521-g004.jpg

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