Abstract
Obstructive sleep apnea (OSA) is a recognized independent risk factor for metabolic disorders, type 2 diabetes mellites (DM2) in particular. Therefore, the study aimed to assess the influence of nocturnal oxygen saturation parameters on the onset of DM2 among OSA patients. The study consisted of 549 participants, who underwent polysomnography examination. Based on apnea hypopnea index (AHI), 465 patients were diagnosed with OSA. One hundred and seven individuals had comorbid DM2. Cox regression models were used to assess the effect of oxygen saturation parameters on the onset of DM2. Classification and regression trees (CART) analysis was used to assess the onset of the DM2 in the study group in context of oxygen saturation variables. One-way Cox regression showed higher risk of earlier DM2 for increased values of BMI, AHI, decreased basal O2 and O2 nadir value, while lowered mean O2 desaturation has not shown statistical significance. In the CART analysis, the following cut-off points 92.2%, 81.7%, 87.1% were determined for basal O2, O2 nadir and mean O2 desaturation, respectively, with the first two parameters being statistically significant. Therefore, basal O2 is independent from AHI, BMI and age is a risk factor of DM2 among OSA patients.
Highlights
Type 2 diabetes mellitus (DM2) is one of the most prevalent civilizational diseases and is associated with great morbidity and mortality [1]
Obstructive sleep apnea (OSA) is a common sleep respiratory disease characterized by repetitive collapse of upper airways resulting in sleep fragmentation and nocturnal recurrent intermittent hypoxia (IH), which manifests as desaturations in polysomnography (PSG)
The following inclusion criteria were applied in the study: age 18–70 and body mass index (BMI) 20–45 kg/m2 patients were excluded from the study if their total sleep time was shorter than three hours, if sleep time either in lateral or supine position was shorter than half an hour or if total REM sleep was shorter than half an hour
Summary
Type 2 diabetes mellitus (DM2) is one of the most prevalent civilizational diseases and is associated with great morbidity and mortality [1]. It is important to identify potentially modifiable risk factors for DM2. Prevalence estimation shows that around one billion adults worldwide could have OSA (apnea—hypopnea index [AHI] ≥ 5/h) [2]. Considering the scale of the problem it is important to properly recognize and treat many chronic medical conditions associated with OSA such as hypertension, coronary artery disease and metabolic disorders [3,4]. Numerous studies have provided evidence that OSA may be independent from other classic risk factors as a determinant for incident DM2 [5,6,7]
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