Association of parameters of nocturnal hypoxemia with diabetic microvascular complications: a cross-sectional study
作者单位：Sleep Medicine Center West China Hospital Sichuan University Department of Endocrinology and Metabolism West China Hospital Sichuan University
会议名称：《中国睡眠研究会第十一届全国学术年会》
会议日期：2019年
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
关 键 词：nocturnal hypoxemia obstructive sleep apnea diabetic peripheral neuropathy diabetic retinopathy diabetic nephropathy
摘 要：Background Diabetic microvascular complications are very common in patients with type 2 diabetes mellitus(T2DM) and contribute significantly to the morbidity and mortality of the condition. A growing body of literature suggests that obstructive sleep apnea(OSA) is a recognized risk factor for T2DM, and may also be a potential risk factor for diabetic microvascular complications. OSA and hyperglycemia share many similar molecular consequences. However, whether OSA defined by apnea-hypopnea index(AHI) or oxygen desaturation index(ODI) is associated with development of diabetic microvascular complications remains controversial. Objective The aim of this study was to examine the association between hypoxemia parameters related to OSA and microvascular complications(i.e., diabetic peripheral neuropathy(DPN), diabetic retinopathy(DR) and diabetic nephropathy(DN)). Methods A total of 468 Chinese patients with type 2 diabetes aged 18-85 years were included in the study. Information on demographic features, lifestyle risk factors, family history of diabetes, history and treatment of comorbidities was collected. All participants underwent one-night polysomnography, followed by the screening of diabetic microvascular complications, which were diagnosed by medical specialists. Parameters of nocturnal hypoxemia including AHI, ODI, mean and lowest oxygen saturation(SpO), and time spent with SpO90% or 85% were recorded. Student t-test, Wilcoxon rank test and chi-square test were used to analyze data. Logistic regression analysis was used to determine the independent association between various parameters of nocturnal hypoxemia and the odds of diabetic microvascular complications after adjusting for potential confounders. Statistical significance was accepted as a two-sided test with an alpha level of 0.05. Results Patients with diabetic microvascular complications(i.e. DPN, DR or DN) were older and more likely to have long diabetes duration and a history of hypertension compared