Chunmin Du1, Chunmei He2, Lianqin Dong3, Silan Zheng1, Wengui Wang4, Caiyu Zheng1, Shunhua Wang4, MingZhu Lin4, Shuyu Yang2, Xuejun Li4, Zhibin Li5, Changqin Liu6,7. 1. School of Medicine, Xiamen University, Xiamen, China. 2. Xiamen Diabetes Institute, The First Affiliated Hospital, Xiamen University, Xiamen, China. 3. The School of Clinical Medicine, Fujian Medical University, Fuzhou, China. 4. Department of Endocrinology and Diabetes, The First Affiliated Hospital, Xiamen University, Xiamen, China. 5. Epidemiology Research Unit, The First Affiliated Hospital, Xiamen University, Xiamen, China. zhibinli33@hotmail.com. 6. The School of Clinical Medicine, Fujian Medical University, Fuzhou, China. liuchangqin@xmu.edu.cn. 7. Department of Endocrinology and Diabetes, The First Affiliated Hospital, Xiamen University, Xiamen, China. liuchangqin@xmu.edu.cn.
Abstract
PURPOSE: The relationship between obstructive sleep apnea (OSA) and diabetic microvascular complications (DMC) are controversial. Whether low education is associated with increased risk of DMC independently of poor lifestyles are currently unknown. The aim of this study is to explore the independent associations of different PSG index and educational attainment with risks of DR, DKD, and DPN. METHODS: A cross-sectional study of 330 patients with T2DM who underwent overnight polysomnography (PSG) tests. Multivariable logistic regression analysis was performed to determine the associations of PSG index and educational attainments with DR, DKD, and DPN. RESULTS: The prevalence rates of DMC were 30.6% for DR, 24.9% for DKD, and 64.6% for DPN. All PSG index (AHI, REM-AHI, NREM-AHI, the severity of OSAS, ODI, MAI, and lowest SaO2) were not significantly associated with risks of DR, DKD, or DPN with adjustment for potential confounding factors. Subjects with increasing educational attainments showed significantly decreased prevalence rates of DR (42.6, 27.3, and 21.3%, p = 0.005), DKD (31.7, 25.3, and 14.7%, p = 0.035) and DPN (74.3, 63.6, and 53.3%, p = 0.015), respectively. Logistic regression analyses showed that educational attainment of primary or below showed significantly increased risks of DR (OR (95% CIs): 3.596 (1.453-8.899, p = 0.006)) and DKD (OR (95% CIs): 3.201 (1.244-8.242, p = 0.016)) as compared with that of college or above. There were significant trends of lower educational attainment with increased risks of DR and DKD (p values < 0.05). CONCLUSION: PSG index were not significantly associated with DMC. But lower education was significantly associated with increased risks of DR and DKD, and strategies to prevent DMC for those with low education should be strengthened.
PURPOSE: The relationship between obstructive sleep apnea (OSA) and diabetic microvascular complications (DMC) are controversial. Whether low education is associated with increased risk of DMC independently of poor lifestyles are currently unknown. The aim of this study is to explore the independent associations of different PSG index and educational attainment with risks of DR, DKD, and DPN. METHODS: A cross-sectional study of 330 patients with T2DM who underwent overnight polysomnography (PSG) tests. Multivariable logistic regression analysis was performed to determine the associations of PSG index and educational attainments with DR, DKD, and DPN. RESULTS: The prevalence rates of DMC were 30.6% for DR, 24.9% for DKD, and 64.6% for DPN. All PSG index (AHI, REM-AHI, NREM-AHI, the severity of OSAS, ODI, MAI, and lowest SaO2) were not significantly associated with risks of DR, DKD, or DPN with adjustment for potential confounding factors. Subjects with increasing educational attainments showed significantly decreased prevalence rates of DR (42.6, 27.3, and 21.3%, p = 0.005), DKD (31.7, 25.3, and 14.7%, p = 0.035) and DPN (74.3, 63.6, and 53.3%, p = 0.015), respectively. Logistic regression analyses showed that educational attainment of primary or below showed significantly increased risks of DR (OR (95% CIs): 3.596 (1.453-8.899, p = 0.006)) and DKD (OR (95% CIs): 3.201 (1.244-8.242, p = 0.016)) as compared with that of college or above. There were significant trends of lower educational attainment with increased risks of DR and DKD (p values < 0.05). CONCLUSION: PSG index were not significantly associated with DMC. But lower education was significantly associated with increased risks of DR and DKD, and strategies to prevent DMC for those with low education should be strengthened.
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