Nocturnal oxygen desaturation correlates with glycemia levels in patients with coronary artery disease.

AIM: Sleep-disordered breathing (SDB) has a high occurrence in patients with coronary artery disease. The aim of the present study was to examine the relationships between the overnight oxygen desaturation index (ODI) and metabolic and anthropometric parameters in a sample of patients who underwent percutaneous transluminal coronary angioplasty (PTCA). METHODS: The overnight pulse-oximetry recording ODI (desaturation >4%, length >10 s/events per hour) was performed in 29 patients with coronary heart disease, after they underwent PTCA. All study participants performed dynamic spirometric test, echocardiography, anthropometric measurements, bio impedance analysis. Fasting blood sample was collected to measure metabolic parameters. Using ODI category, the patients were grouped as follows: group N, N.=9 (ODI= or <5 events/hour); group A, N.=14 (515 events/hour). RESULTS: Among the studied patients, 69% had a nocturnal ODI>5 and 48% had a nocturnal ODI between 5 and 15 events/hour. ODI values were correlated with body mass index (BMI) (P<0.05) but not with waist to hip ratio, or percent body fat. After adjustment for BMI values, there was a significant positive correlation of ODI values with fasting glucose serum levels (P<0.05). CONCLUSION: These data suggest that early metabolic dysfunction may occur with SDB before overt clinical manifestation of underlying disease in patients with preobesity and ischemic heart disease. Patients with ischemic heart disease should be screened for SDB by ODI, also according to fasting glucose levels.

Pattern of abnormal tangential forces in the diabetic neuropathic foot.

OBJECTIVES: The role of tangential stress in neuropathic foot ulceration is yet unknown. The aim of this study was to investigate the tangential forces developed during gait by the whole foot and by selected subareas of it, namely the heel, the metatarsals and the hallux. METHODS: 61 diabetic patients have been evaluated: 27 without neuropathy, 19 with neuropathy and 15 with previous neuropathic ulcer. The patients were compared with 21 healthy volunteers. A piezo-dynamometric platform was used to measure the three components of the ground reaction force under the total foot and the selected subareas. RESULTS: A significant reduction was observed for the forward peak and the backward peak of the anteroposterior ground reaction force component measured under the whole foot. Patients with previous neuropathic ulcer showed a significant increase of the mediolateral stress under the metatarsals. CONCLUSIONS: Tangential stress is altered in diabetic neuropathic patients; the increased mediolateral component suggests that tangential stress could have a role in the high risk of recurrence observed in patients with previous ulceration. RELEVANCE: To assess the effectiveness of a non-invasive methodology for the estimation and the monitoring of significant alterations of the tangential stress with the increase of neuropathy.