Sleep apnea and glucose metabolism: a long-term follow-up in a community-based sample
2012 (English)In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 142, no 4, 935-942 p.Article in journal (Refereed) Published
It has been suggested that sleep-disordered breathing (SDB) is a risk factor for diabetes, but long-term follow-ups are lacking. The aim of this community-based study was to analyze the influence of SDB on glucose metabolism after more than 10 years.
Men without diabetes (n=141, mean age 57.5 years) were investigated at baseline, including whole-night respiratory monitoring. After a mean period of 11 years and 4 months, they were followed up with an interview, anthropometric measurements and blood sampling. Insulin resistance was quantified using the homeostasis model assessment (HOMA). ΔHOMA-IR was calculated as (HOMA-IR(follow-up) - HOMA-IR(baseline)). An oral glucose tolerance test was performed in 113 men to calculate the insulin sensitivity index (ISI).
The mean apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) at baseline were 4.7 and 3.3, respectively. At the follow-up, 23 men had diabetes. An oxygen desaturation index (ODI) of >5 was a predictor of developing diabetes (adj. OR 4.4, 95% CI 1.1-18.1 after adjusting for age, BMI(baseline,) ΔBMI, hypertension and years with CPAP during the period). The ODI was inversely related to the ISI at the follow-up (r= -0.27, p=0.003). A deterioration in HOMA-IR was significantly related to all variables of sleep-disordered breathing (AHI, AHI>5, ODI, ODI>5 and MinSaO2) even when adjusting for confounders. When excluding the variable "years on CPAP" from the multivariate model, all associations weakened.
SDB is independently related to the development of insulin resistance and thereby the risk of manifest diabetes mellitus.
Place, publisher, year, edition, pages
2012. Vol. 142, no 4, 935-942 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-191208DOI: 10.1378/chest.11-1844ISI: 000317153200019PubMedID: 22499826OAI: oai:DiVA.org:uu-191208DiVA: diva2:585055