Association between severity of obstructive sleep apnea and glycated hemoglobin level in Japanese individuals with and without diabetes

Kurosawa, Hiroyuki; Saisho, Yoshifumi; Fukunaga, Koichi; Haraguchi, Mizuha; Yamasawa, Wakako; Kurihara, Isao; Betsuyaku, Tomoko; Itoh, Hiroshi

doi:10.1507/endocrj.ej17-0356

Cited by 18 publications

(19 citation statements)

References 22 publications

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“…Data from Pamidi et al, in lean OSAS patients, support the specific impact of OSAS on insulin resistance occurrence [25]. The severity of OSAS has been shown to be associated with increased HbA1c levels [26,27] independently of BMI, especially in those without DM [27], and with worse glycemic control (HbA1c levels 0.72% higher) in DM patients [23]. However, we did not observe this association for the whole cohort or in newly diagnosed DM.…”

Section: Discussionsupporting

confidence: 42%

Prevalence of undiagnosed glucose intolerance and type 2 diabetes in patients with moderate-to-severe obstructive sleep apnea syndrome

2019

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Purpose Overweight and obesity are major causal factors for obstructive sleep apnea syndrome (OSAS), providing insight into why one third of patients with OSAS suffer from diabetes mellitus and another third from glucose intolerance. However, a significant proportion of the general population remains undiagnosed for glucose metabolism disorders. The primary aim of this study was to establish the prevalence of known and newly diagnosed glucose metabolism disorders in patients with moderate and severe OSAS referred to the sleep lab for continuous positive airway pressure (CPAP) therapy. Methods We prospectively included consecutive patients with moderate or severe OSAS referred for CPAP therapy. A fasting blood sample was collected to determine glycosylated hemoglobin (HbA1c), glucose, and homeostatic model assessment (HOMA) index. Baseline demographic data and medication intake were recorded. Results Of 280 consecutive patients (70% men, mean ± SD body mass index 33 ± 7 kg/m 2 , apnea-hypopnea index 49 ± 25), 22% exhibited diabetes and 44% glucose intolerance. Undiagnosed diabetes and glucose intolerance was found in 79 of 280 patients (28%). Insulin resistance was associated with OSAS severity in multivariate linear regression analysis (regression coefficient 2.40 [95% CI 0.07-4.72]; p = 0.04). Conclusion In this population of overweight and obese patients with moderate and severe OSAS, 66% of patients had diabetes or glucose intolerance and 28% were newly diagnosed. Diabetes and glucose intolerance were not related to OSAS severity, contrary to insulin resistance. These data suggest that there is value in systematic screening for glucose metabolism disorders in all patients with moderate and severe OSAS.

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Section: Discussionsupporting

confidence: 42%

Prevalence of undiagnosed glucose intolerance and type 2 diabetes in patients with moderate-to-severe obstructive sleep apnea syndrome

2019

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“…[18] In yet another study, the severity of OSA was associated with increased HbA1c level independent of body mass index in Japanese individuals, especially in those without diabetes. [19]…”

Section: Discussionmentioning

confidence: 99%

Evaluation of obstructive sleep apnea in metabolic syndrome

Soin

Kumar

Chahal

et al. 2019

J Family Med Prim Care

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Background: Metabolic syndrome has become one of the most important public health problems with a growing prevalence in both developed and developing countries. Obesity is a major risk factor for obstructive sleep apnea (OSA), which is associated with significant cardiorespiratory morbidity. Aims: The aims of this study were to find out the prevalence of OSA in patients with metabolic syndrome and to highlight the importance of assessment of OSA in these patients. Methods: This cross-sectional analytical study was conducted on 100 subjects aged 30–60 years, comprising 50 cases of metabolic syndrome and 50 controls without metabolic syndrome. Overnight polysomnography was done in all the subjects. Prevalence and severity of OSA were assessed and compared between the two groups. Results: Prevalence of OSA was significantly higher (66%) in patients with metabolic syndrome than in subjects without metabolic syndrome (12%). Out of 33 (66%) OSA patients with metabolic syndrome, 8 (16%) had mild OSA, 11 (22%) had moderate OSA, and 14 (28%) had severe OSA. Increasing severity of OSA was associated with higher mean levels of all the metabolic syndrome parameters except serum high density lipoprotein (HDL). Conclusions: OSA is highly prevalent in patients with metabolic syndrome. Also, the increasing severity of OSA is associated with poorer control of diabetes, hypertension, and dyslipidemia, which are all components of metabolic syndrome. Therefore, effective treatment of metabolic syndrome can prevent and control OSA in these patients. Similarly, reducing the severity of OSA (by early diagnosis and treatment) in patients with metabolic syndrome might help to optimize control of blood sugar, blood pressure, and serum lipids, thereby reducing the risk of cardiovascular disease. Therefore, the need for screening metabolic syndrome patients for OSA has been reinforced by this study.

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“…Yarmolinsky et al [9] observed the protective effects of coffee consumption on diabetes mainly through the effect on postprandial blood glucose. A recent study [31] conducted in Japan found that the severity of obstructive sleep apnea is associated with higher glycated hemoglobin especially among patients without diabetes. Interestingly the study observed that the Apnea–hypopnea index (AHI)was significantly associated with HbA1c level in total and non-diabetic individuals but not in those with type 2 diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

The relationship between coffee intake, obstructive sleep apnea risk, and type 2 diabetes glycemic control, in Tabuk City, The Kingdom of Saudi Arabia: a case–control study

et al. 2019

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ObjectivesThe study aimed to assess the relationship between coffee intake, obstructive sleep apnea risk (OSA), and glycemic control among patients with diabetes mellitus.ResultsThere were 110 patients with diabetes and 96 healthy control subjects (matched for age and sex) attending a diabetes center زinTabuk, Saudi Arabia during the period from June 2018–October 2019. Stop-Bang questionnaire was used to assess OSA risk, and Epworth Sleepiness Scale to investigate daytime sleepiness. OSA risk and daytime sleepiness were higher among patients with diabetes compared to controls (4.34 ± 1.61 vs. 2.86 ± 1.24, and 8.31 ± 4.40 vs. 6.39 ± 3.70 respectively, P < 0.5), while coffee consumption was not (4.64 ± 3.95 vs. 3.45 ± 3.06, P > 0.05). Women with diabetes were younger with short duration since the diagnosis of diabetes and consumed less coffee compared to men, P < 0.5. A negative correlation was found between coffee consumption and the duration of diabetes, while no correlation was found between coffee intake, the glycated hemoglobin, OSA risk, sex, and daytime sleepiness. Daytime sleepiness and OSA risk were commoners among patients with diabetes, they were not correlated with coffee consumption which was negatively correlated with the duration since diabetes diagnosis. Further larger multi-center studies investigating coffee intake among patients newly diagnosed with diabetes are recommended.

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Association between severity of obstructive sleep apnea and glycated hemoglobin level in Japanese individuals with and without diabetes

Cited by 18 publications

References 22 publications

Prevalence of undiagnosed glucose intolerance and type 2 diabetes in patients with moderate-to-severe obstructive sleep apnea syndrome

Prevalence of undiagnosed glucose intolerance and type 2 diabetes in patients with moderate-to-severe obstructive sleep apnea syndrome

Evaluation of obstructive sleep apnea in metabolic syndrome

The relationship between coffee intake, obstructive sleep apnea risk, and type 2 diabetes glycemic control, in Tabuk City, The Kingdom of Saudi Arabia: a case–control study

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