Takayasu Uchida1, Akihiro Nishimura2, Takatoshi Kasai3,4, Shota Kikuno1, Kaoru Nagasawa1, Minoru Okubo1, Koji Narui3, Yasumichi Mori1. 1. Department of Endocrinology and Metabolism, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. 2. Department of Endocrinology and Metabolism, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. toranishi@gmail.com. 3. Sleep Center, Toranomon Hospital, Tokyo, Japan. 4. Department of Cardiovascular Medicine, Cardiovascular Respiratory Sleep Medicine, Juntendo University, Tokyo, Japan.
Abstract
PURPOSE: Sleep-disordered breathing (SDB) is associated with hypertension, poor glycemic control and dyslipidemia. Usually, apnoea events tend to be more prominent during rapid eye movement (REM) sleep than non-REM (NREM) sleep. We examined which SDB parameters are associated with blood pressure (BP), HbA1c and lipid profile in patients with type 2 diabetes (T2D). METHODS: A total of 185 patients with T2D who underwent polysomnography were analysed. Exclusion criteria were: the presence of pulmonary diseases, central sleep apnoea, treated SDB, or REM sleep < 30 min. To predict BP, HbA1c, and lipid profiles, we performed multiple linear regression analyses adjusted for known risk factors. Subsequently, we performed multivariable logistic regression analyses. RESULTS: Patient characteristics (mean ± standard deviation/median) were as follows: age 58.0 ± 11.8 years, body mass index 26.0 kg/m2 (24.1-28.9 kg/m2 ), systolic BP 134 ± 19 mmHg, mean BP 98 ± 14 mmHg, HbA1c 7.4% (6.8-8.4%), triglyceride 143 mg/dL (97-195 mg/dL), non-high density lipoprotein (non-HDL) cholesterol 143 mg/dL (120-163 mg/dL), REM-apnoea-hypopnea index (AHI) 35.1/h (21.1-53.1/h). The analyses revealed that REM-AHI was independently associated with systolic and mean BP, whereas NREM-AHI was not. A statistically significant association was not observed between REM-AHI and HbA1c or lipid profile. CONCLUSION: In patients with T2D, REM-AHI was associated with systolic and mean BP. The alteration of BP, associated with SDB during REM sleep, may be an important pathophysiological link between SDB and cardiovascular diseases.
PURPOSE:Sleep-disordered breathing (SDB) is associated with hypertension, poor glycemic control and dyslipidemia. Usually, apnoea events tend to be more prominent during rapid eye movement (REM) sleep than non-REM (NREM) sleep. We examined which SDB parameters are associated with blood pressure (BP), HbA1c and lipid profile in patients with type 2 diabetes (T2D). METHODS: A total of 185 patients with T2D who underwent polysomnography were analysed. Exclusion criteria were: the presence of pulmonary diseases, central sleep apnoea, treated SDB, or REM sleep < 30 min. To predict BP, HbA1c, and lipid profiles, we performed multiple linear regression analyses adjusted for known risk factors. Subsequently, we performed multivariable logistic regression analyses. RESULTS:Patient characteristics (mean ± standard deviation/median) were as follows: age 58.0 ± 11.8 years, body mass index 26.0 kg/m2 (24.1-28.9 kg/m2 ), systolic BP 134 ± 19 mmHg, mean BP 98 ± 14 mmHg, HbA1c 7.4% (6.8-8.4%), triglyceride 143 mg/dL (97-195 mg/dL), non-high density lipoprotein (non-HDL) cholesterol 143 mg/dL (120-163 mg/dL), REM-apnoea-hypopnea index (AHI) 35.1/h (21.1-53.1/h). The analyses revealed that REM-AHI was independently associated with systolic and mean BP, whereas NREM-AHI was not. A statistically significant association was not observed between REM-AHI and HbA1c or lipid profile. CONCLUSION: In patients with T2D, REM-AHI was associated with systolic and mean BP. The alteration of BP, associated with SDB during REM sleep, may be an important pathophysiological link between SDB and cardiovascular diseases.
Entities:
Keywords:
Diabetes mellitus, type 2; Hypertension; Sleep apnoea syndromes; Sleep, REM
Authors: Babak Mokhlesi; Laurel A Finn; Erika W Hagen; Terry Young; Khin Mae Hla; Eve Van Cauter; Paul E Peppard Journal: Am J Respir Crit Care Med Date: 2014-11-15 Impact factor: 21.405
Authors: José M Marin; Alvar Agusti; Isabel Villar; Marta Forner; David Nieto; Santiago J Carrizo; Ferran Barbé; Eugenio Vicente; Ying Wei; F Javier Nieto; Sanja Jelic Journal: JAMA Date: 2012-05-23 Impact factor: 56.272
Authors: Richard B Berry; Rohit Budhiraja; Daniel J Gottlieb; David Gozal; Conrad Iber; Vishesh K Kapur; Carole L Marcus; Reena Mehra; Sairam Parthasarathy; Stuart F Quan; Susan Redline; Kingman P Strohl; Sally L Davidson Ward; Michelle M Tangredi Journal: J Clin Sleep Med Date: 2012-10-15 Impact factor: 4.062
Authors: Sarah L Appleton; Andrew Vakulin; Sean A Martin; Carol J Lang; Gary A Wittert; Anne W Taylor; R Doug McEvoy; Nick A Antic; Peter G Catcheside; Robert J Adams Journal: Chest Date: 2016-03-19 Impact factor: 9.410