Sleep apnea and glucose metabolism: a long-term follow-up in a community-based sample.
Chest
; 142(4): 935-942, 2012 Oct.
Article
em En
| MEDLINE
| ID: mdl-22499826
ABSTRACT
BACKGROUND:
It has been suggested that sleep-disordered breathing (SDB) is a risk factor for diabetes, but long-term follow-up studies are lacking. The aim of this community-based study was to analyze the influence of SDB on glucose metabolism after > 10 years.METHODS:
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 of insulin resistance (HOMA-IR). ΔHOMA-IR was calculated as (HOMA-IR at follow-up − HOMA-IR at baseline). An oral glucose tolerance test was performed on 113 men to calculate the insulin sensitivity index.RESULTS:
The mean apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) at baseline were 4.7 and 3.3, respectively. At follow-up, 23 men had diabetes. An ODI > 5 was a predictor of developing diabetes (OR, 4.4; 95% CI, 1.1-18.1, after adjusting for age, BMI, and hypertension at baseline and ΔBMI and years with CPAP during follow-up). The ODI was inversely related to the insulin sensitivity index at follow-up (r = −0.27, P = .003). A deterioration in HOMA-IR was significantly related to all variables of SDB (AHI, AHI > 5; ODI, ODI > 5; minimum arterial oxygen saturation), even when adjusting for confounders. When excluding the variable years with CPAP from the multivariate model, all associations weakened.CONCLUSIONS:
SDB is independently related to the development of insulin resistance and, thereby, the risk of manifest diabetes mellitus.
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Base de dados:
MEDLINE
Assunto principal:
Síndromes da Apneia do Sono
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Glicemia
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Resistência à Insulina
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Vigilância da População
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Diabetes Mellitus
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article