Weijuan Su1,2, Guobing Chen3, Danyan Ma4, Jinyang Zeng1,2, Fangfang Yan1,2, Xiaoyan Lin1,2, Ziqing Xu1,2, Shuyu Yang5, Zhibin Li6, Changqin Liu1,2,7. 1. Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, China. 2. Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, China. 3. Department of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, China. 4. School of Medicine, Xiamen University, Xiamen, China. 5. Xiamen Diabetes Institute, The First Affiliated Hospital, Xiamen University, Xiamen, China. 6. Epidemiology Research Unit, Center of Translational Medical Research, The First Affiliated Hospital of Xiamen University, Xiamen, China. 7. The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
Abstract
OBJECTIVE: The current study aimed to explore the relationship between OSAS and hypertension and whether polysomnography (PSG) indices were independently associated with hypertension in patients with type 2 diabetes (T2DM). METHODS: This study recruited 316 T2DM patients. Multivariable logistic regression analyses were performed to determine the independent association of apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) with hypertension with adjustment for potential confounders. RESULTS: Among 316 patients, 130 (41.1%) and 204 (64.6%) had hypertension and OSAS, respectively. T2DM patients with hypertension showed significantly increased levels of AHI ((median (interquartile range)): 17.2 (5.7-34.9) vs. 5.7 (2.1-17.3) events/hour, p < 0.001), nonrapid eye movement AHI (NREM-AHI) (17.6 (5.5-36.5) vs. 5.2 (2.2-16.6) events/hour, p < 0.001), ODI (48.4 (21.9-78.0) vs. 22.6 (10.8-48.1) events/hour, p < 0.001), and severities of OSAS and decreased levels of lowest SaO2 ((mean ± standard deviation): 74.0 ± 10.4 vs. 77.3 ± 9.8, p = 0.004). Multivariable logistic regression analysis showed that higher levels of AHI, NREM-AHI, and ODI were significantly associated with increased risks of hypertension, and the adjusted odds ratios (ORs) with 95% CI were 1.026 (1.008-1.044, p = 0.004), 1.026 (1.009-1.044, p = 0.003), and 1.005 (1.001-1.010, p = 0.040), respectively. Compared with non-OSAS, severe OSAS was significantly associated with the risk of hypertension with the adjusted OR (95% CI) of 3.626 (1.609-8.172, p = 0.002), but associations of rapid eye movement AHI (REM-AHI) and lowest SaO2 with hypertension were not statistically significant. CONCLUSION: Increased AHI, NREM-AHI, ODI, and severities of OSAS were significantly associated with higher risks of hypertension in T2DM patients. Detection and treatment of OSAS are needed to prevent hypertension in T2DM patients.
OBJECTIVE: The current study aimed to explore the relationship between OSAS and hypertension and whether polysomnography (PSG) indices were independently associated with hypertension in patients with type 2 diabetes (T2DM). METHODS: This study recruited 316 T2DM patients. Multivariable logistic regression analyses were performed to determine the independent association of apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) with hypertension with adjustment for potential confounders. RESULTS: Among 316 patients, 130 (41.1%) and 204 (64.6%) had hypertension and OSAS, respectively. T2DM patients with hypertension showed significantly increased levels of AHI ((median (interquartile range)): 17.2 (5.7-34.9) vs. 5.7 (2.1-17.3) events/hour, p < 0.001), nonrapid eye movement AHI (NREM-AHI) (17.6 (5.5-36.5) vs. 5.2 (2.2-16.6) events/hour, p < 0.001), ODI (48.4 (21.9-78.0) vs. 22.6 (10.8-48.1) events/hour, p < 0.001), and severities of OSAS and decreased levels of lowest SaO2 ((mean ± standard deviation): 74.0 ± 10.4 vs. 77.3 ± 9.8, p = 0.004). Multivariable logistic regression analysis showed that higher levels of AHI, NREM-AHI, and ODI were significantly associated with increased risks of hypertension, and the adjusted odds ratios (ORs) with 95% CI were 1.026 (1.008-1.044, p = 0.004), 1.026 (1.009-1.044, p = 0.003), and 1.005 (1.001-1.010, p = 0.040), respectively. Compared with non-OSAS, severe OSAS was significantly associated with the risk of hypertension with the adjusted OR (95% CI) of 3.626 (1.609-8.172, p = 0.002), but associations of rapid eye movement AHI (REM-AHI) and lowest SaO2 with hypertension were not statistically significant. CONCLUSION: Increased AHI, NREM-AHI, ODI, and severities of OSAS were significantly associated with higher risks of hypertension in T2DM patients. Detection and treatment of OSAS are needed to prevent hypertension in T2DM patients.
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