Sakurako Tanno1, Takeshi Tanigawa2, Isao Saito3, Wataru Nishida4, Koutatsu Maruyama5, Eri Eguchi6, Susumu Sakurai7, Haruhiko Osawa4, Naresh M Punjabi8. 1. Department of Public Health, Ehime University Graduate School of Medicine, Toon, Japan; Center of Sleep Medicine, Ehime University Hospital, Toon, Japan. 2. Department of Public Health, Ehime University Graduate School of Medicine, Toon, Japan. Electronic address: tt9178tt9178@gmail.com. 3. Department of Basic Nursing and Health Science, Ehime University Graduate School of Medicine, Toon, Japan. 4. Department of Molecular and Genetic Medicine, Ehime University Graduate School of Medicine, Toon, Japan. 5. Department of Basic Medical Research and Education, Ehime University Graduate School of Medicine, Toon, Japan. 6. Department of Public Health, Ehime University Graduate School of Medicine, Toon, Japan. 7. Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, Tenri, Japan. 8. Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.
Abstract
BACKGROUND: Intermittent hypoxemia is a fundamental pathophysiological consequence of sleep-disordered breathing and may alter glucose metabolism. To characterize the association between sleep-related intermittent hypoxemia and glucose metabolism, overnight pulse-oximetry and an oral glucose tolerance test were completed in a cohort of middle-aged and older Japanese adults. METHODS: The study sample consisted of 1836 community-dwelling Japanese (age, 30-79 years; women, 65.5%; mean body mass index, 23.1 kg/m(2)). The oxygen desaturation index (ODI) was quantified during sleep using a ≥3% oxygen desaturation threshold and categorized as normal (<5.0 events/h), mild (5.0-15.0 events/h), and moderate to severe (≥15.0 events/h). The independent associations between the ODI and the prevalence of impaired fasting glucose, impaired glucose tolerance, diabetes, and two metrics of insulin resistance [homeostasis model assessment index for insulin resistance (HOMA-IR) and Matsuda index] were examined. RESULTS: Compared with subjects with an ODI < 5 events/h, the adjusted odds ratio for prevalent impaired fasting glucose, glucose intolerance, and diabetes for subjects with an ODI ≥15.0 events/h were 1.27 (95% confidence interval, 0.72-2.23), 1.69 (1.03-2.76), and 1.28 (0.59-2.79), respectively. Both HOMA-IR and Matsuda index were significantly associated with the severity of sleep-related intermittent hypoxemia as assessed by the ODI (P for trend = 0.03 and 0.007, respectively). CONCLUSION: Among middle-aged and older Japanese adults, sleep-related intermittent hypoxemia is associated with glucose intolerance and insulin resistance, and may contribute to the development of type 2 diabetes mellitus.
BACKGROUND: Intermittent hypoxemia is a fundamental pathophysiological consequence of sleep-disordered breathing and may alter glucose metabolism. To characterize the association between sleep-related intermittent hypoxemia and glucose metabolism, overnight pulse-oximetry and an oral glucose tolerance test were completed in a cohort of middle-aged and older Japanese adults. METHODS: The study sample consisted of 1836 community-dwelling Japanese (age, 30-79 years; women, 65.5%; mean body mass index, 23.1 kg/m(2)). The oxygen desaturation index (ODI) was quantified during sleep using a ≥3% oxygen desaturation threshold and categorized as normal (<5.0 events/h), mild (5.0-15.0 events/h), and moderate to severe (≥15.0 events/h). The independent associations between the ODI and the prevalence of impaired fasting glucose, impaired glucose tolerance, diabetes, and two metrics of insulin resistance [homeostasis model assessment index for insulin resistance (HOMA-IR) and Matsuda index] were examined. RESULTS: Compared with subjects with an ODI < 5 events/h, the adjusted odds ratio for prevalent impaired fasting glucose, glucose intolerance, and diabetes for subjects with an ODI ≥15.0 events/h were 1.27 (95% confidence interval, 0.72-2.23), 1.69 (1.03-2.76), and 1.28 (0.59-2.79), respectively. Both HOMA-IR and Matsuda index were significantly associated with the severity of sleep-related intermittent hypoxemia as assessed by the ODI (P for trend = 0.03 and 0.007, respectively). CONCLUSION: Among middle-aged and older Japanese adults, sleep-related intermittent hypoxemia is associated with glucose intolerance and insulin resistance, and may contribute to the development of type 2 diabetes mellitus.
Authors: Mirja Quante; Rui Wang; Jia Weng; Carol L Rosen; Raouf Amin; Susan L Garetz; Eliot Katz; Shalini Paruthi; Raanan Arens; Hiren Muzumdar; Carole L Marcus; Susan Ellenberg; Susan Redline Journal: Sleep Date: 2015-09-01 Impact factor: 5.849