The relationship between obstructive sleep apnea hypopnea syndrome and renal function in patients with type 2 diabetes mellitus

Abstract

Objective To observe the effect of obstructive sleep apnea hypopnea syndrome (OSAHS) on the renal function in patients with type 2 diabetes mellitus (T2DM). Methods Sleep apnea hypopnea index (AHI), oxygen desaturation index (ODI), and nighttime lowest oxygen saturation (LSaO2) were evaluated in 298 patients with T2DM using a portable sleep apnea monitor. Patients were divided into T2DM without OSAHS group (n=120) and with OSAHS group (n=178) according to AHI 90 ml·min-1·(1.73 m2)-1 (n=190), 90>eGFR>60 ml·min-1·(1.73 m2)-1 (n=84), eGFR<60 ml·min-1·(1.73 m2)-1 (n=24). The influencing factors of eGFR and AHI were analyzed by logistic regression analysis. Results There were significant differences in eGFR, uric acid (UA), high density lipoprotein-cholesterol (HDL-C), waist circumference, hip circumference, body mass index (BMI), and urinary albumin between T2DM without OSAHS and with OSAHS groups(all P<0.05). eGFR showed a significant correlation with AHI(r=-0.154, P=0.008), ODI(r=-0.236, P<0.01), and LSaO2(r=0.145, P=0.024). Logistic regression revealed that eGFR(OR=0.991, 95%CI 0.983~0.998, P=0.014), BMI(OR=1.107, 95%CI 1.028~1.193, P=0.008)were independent risk factors for AHI. There were significant differences in age, urinary albumin, AHI, ODI, LSaO2 among groups with various eGFR levels (P<0.05). Stepwise regression showed that age(β=-0.456, 95%CI -0.571~-0.346, P<0.01)and AHI(β=-0.119, 95%CI -0.226~-0.007, P=0.037) were independent risk factors for eGFR. Conclusions OSAHS is a risk factor for renal impairment in patients with T2DM. (Chin J Endocrinol Metab, 2017, 33: 552-555) Key words: Obstructive sleep apnea hypopnea syndrome; Diabetes mellitus, type 2; Chronic kidney disease