Abstract 6283: Obstructive Sleep Apnea Syndrome Associated with Major Cardiovascular Events in Male Diabetic Patients

Abstract

Obstructive sleep apnea syndrome (OSAS), an obesity comorbidity, is an independent risk factor for diabetes (T2DM) and major cardiovascular events (MACE). While OSAS prevalence and association with MACE are well documented in the general population, such information is not available in T2DM. We analyzed 467 consecutive male T2DM outpatients in whom OSAS was diagnosed through Epworth’s Sleepiness Scale (ESS), overnight oximetry and polysomnography. OSAS (+) (n=43) were compared to OSAS (−) (n=424) regarding cardiovascular (CV) risk factors and MACE. Mean (1SD) age was 64 (12) years, diabetes duration 13 (9) years. Metabolic syndrome prevalence was 77%, HbA1c 7.6 (1.6) %. OSAS prevalence was 9%. There were no differences in age, diabetes duration, smoking, blood pressure and lipids between OSAS (+) and (−). There were significant differences in ESS score, ethanol intake, hypertension, BMI, waist, relative/absolute fat, conicity index, and visceral fat, all higher in OSAS (+) p<0.05. Nasal continuous positive airway pressure was used by 37% of OSAS (+). OSAS (+) were less often in primary prevention (PP) for CV disease than OSAS (−) (43 vs. 66%; p<0.003), with MACE and coronary artery disease (CAD) prevalence 61 and 63% higher (61 vs. 38%; p<0.01 and 44 vs. 27%; p<0.03), as well as much higher stroke prevalence (15 vs. 8%; NS) (see Figure ). OSAS is frequent in male T2DM patients (9%) and associated with a marked increase in MACE and CAD. With gender and diabetes ruled out as confounders, this increase is related to classical and emerging risk factors such as hypertension, BMI, waist, relative/absolute fat, conicity index, and visceral fat.