Diagnostic accuracy of the Berlin questionnaire and therapeutic effect of nasal continuous positive airway pressure in OSAHS patients with glucose metabolic dysfunction

Abstract

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is associated with alterations in glucose metabolism. TheBerlin questionnaire (BQ) is effective in identifying subjects with high risk of OSAHS. However, its validity in patients with glucose metabolic dysfunction remains unclear. Our study aims to examine the diagnostic efficacy ofthe BQ in detecting OSAHS in patients with glucose metabolic dysfunction and toexplore the effect of nasal CPAP on glucose metabolism. Patients with glucose metabolic dysregulation were first asked to complete theBQ and then recruited for polysomnogram (PSG). The diagnostic accuracy of theBQ and the relationships between groups withnormal glucose tolerance (NGT), elevated fasting blood glucose (IFG), impaired glucose tolerance (IGT), and diabetes mellitus (DM) were analyzed. Subjects with both OSAHS and glucose dysregulation received CPAP treatment and underwent an oral glucose tolerance test. Changes inapnea-hypopnea indices (AHI) and glycemic parameters were calculated to determine the efficacy of CPAP. Glycosylated hemoglobin and insulin levels were statistically different between the high-risk and low-risk groups according to theBQ. For diagnosis of subjects withOSAHS who also had glucose metabolic dysfunction, the sensitivity and specificity of theBQ using AHI cut-off values at 5events per hour were 73% and 67%. CPAP therapy effectively reduced the blood glucose, HOMA-IR, and insulin levels. TheBQ can be considered to bean effective and economical screening tool for patieints withOSAHS who also haveglucose metabolic dysfunction. Treatment with CPAP mayimprove glycemic parameters.