Effect of Sleep-Disordered Breathing on Albuminuria in 273 Patients With Type 2 Diabetes

Nishimura, Akihiro; Kasai, Takatoshi; Kikuno, Shota; Nagasawa, Kaoru; Okubo, Minoru; Narui, Koji; Mori, Yusaku

doi:10.5664/jcsm.6986

Cited by 17 publications

(18 citation statements)

References 39 publications

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“…Meanwhile, we also found that AHI, which is a surrogate marker of OSAHS, was independently related to DN. The findings regarding the association between OSAHS and DN are consistent with prior observations [27,29].…”

Section: Discussionsupporting

confidence: 91%

“…DN is a microvascular complications of diabetes. At present, studies regarding the association between OSAHS and DN are scarce and controversial [26][27][28][29]. Furukawa et al [27] showed that five or more 3% oxygen desaturation index (ODI) events per hour might be an independently associated risk factor for microalbuminuria in Japanese women with T2DM after adjustment for confounders, whereby ODI was examined by a pulse oximeter.…”

Section: Discussionmentioning

confidence: 99%

“…However, this study did not analyze other parameters for OSAHS, and the sample size was relatively small. In some other studies [21,29], Sleep-Disorder Breathing (SDB) was defined as a Respiratory Event Index (REI) ≥5 events per hour, which had an independent association with UACR in patients with T2DM. However, in these studies, a portable polygraph, which could neither be used for sleep staging nor distinguish between obstructive sleep apnea and central sleep apnea, was used to assess SDB rather than PSG.…”

Section: Discussionmentioning

confidence: 99%

“…Third, a single measurement of UACR was a limitation of this study due to its fluctuation, which may lead to data drift. Even though previous studies have used a single UACR measurement [21,27,29,35], multiple measurements of UACR values are recommended in clinical settings and for future perspective studies. Finally, the exclusion criteria for this study was to exclude patients receiving OSAHS treatment, but this study included 232 moderate to severe patients who were internationally recommended for continuous positive airway pressure (CPAP) treatment.…”

Section: Discussionmentioning

confidence: 99%

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Association of diabetic nephropathy with the severity of obstructive sleep apnea-hypopnea syndrome in patients with type 2 diabetes mellitus

et al. 2020

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This study aimed to analyze the effect of the severity of obstructive sleep apnea-hypopnea syndrome (OSAHS) on diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM). A total of 322 patients with T2DM participated in this cross-sectional study. OSAHS was diagnosed according to the apnea-hypopnea index (AHI) and it was categorized as follows: normal, mild, moderate, and severe. Relevant clinical data retrieved from medical charts were cross-analyzed between different groups. The relationship between urinary albumin/creatinine ratio(UACR) and OSAHS parameters, which included AHI, lowest oxygen saturation (L-SaO 2 ), and mean oxygen saturation (M-SaO 2 ), was evaluated by partial correlation analysis. DN stages were classified into a non-DN group, a microalbuminuria group, and a macroalbuminuria group. Multiple factor logistic regression analysis was employed to analyze factors influencing DN. The results showed that mild OSAHS, moderate OSAHS, and severe OSAHS patients had a higher Body mass index (BMI), creatinine (CR) level, UACR, and a longer duration of T2DM (p < 0.05) than the non-OSAHS group. The prevalence of DN in the non-OSAHS, mild OSAHS, moderate OSAHS, and severe OSAHS groups was 18.4%, 19.2%, 34.6%, and 49.4%, respectively (p < 0.05). Multiple factor logistic regression analysis revealed that systolic blood pressure (SBP) (OR = 1.03), AHI (OR = 1.02), and duration of T2DM (OR = 1.04) were correlated with DN (p < 0.05). These findings revealed that OSAHS is highly prevalent in T2DM and AHI is independently associated with the presence of DN.OBSTRUCTIVE SLEEP APNEA-HYPOPNEA SYN-DROME (OSAHS) is characterized by the collapse of the upper airway, which leads to hypoxemia and sleep fragmentation. The main symptoms of OSAHS include interval snoring, periods of stopped breathing and waking up during sleep, sweating and excessive urine at night, dizziness and headache in the morning, and daytime fatigue and sleepiness. The prevalence of OSAHS was estimated to be 2-4% in 2004 [1], which increased with increasing age and diagnostic levels. Currently, the mean prevalence of OSAHS among male was 22% (9-37%), while it was 17% (4-50%) among female [2]. However, the majority of OSAHS cases have not been diagnosed and treated in a timely and effective manner.Type 2 diabetes mellitus (T2DM) is a major public health problem due to high rates of morbidity, mortality,

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Association of diabetic nephropathy with the severity of obstructive sleep apnea-hypopnea syndrome in patients with type 2 diabetes mellitus

et al. 2020

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“…Treatment of OSA may help to prevent severe consequences of diabetes. This might indeed be the case, since although glycemic control does not improve during CPAP treatment according to meta-analyses [78, 79], untreated OSA in diabetic patients is associated with increased prevalence of neuropathy [80], peripheral arterial disease [81], diabetic retinopathy [82] and diabetic nephropathy [83–85]. Data on the effects of CPAP on diabetic complications are scarce.…”

Section: Common Comorbidities In Osa Patientsmentioning

confidence: 99%

Obstructive sleep apnea and comorbidities: a dangerous liaison

Bonsignore

Baiamonte

Mazzuca

et al. 2019

Multidiscip Respir Med

179

116

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Obstructive sleep apnea (OSA) is a highly prevalent disease, and is traditionally associated with increased cardiovascular risk. The role of comorbidities in OSA patients has emerged recently, and new conditions significantly associated with OSA are increasingly reported. A high comorbidity burden worsens prognosis, but some data suggest that CPAP might be protective especially in patients with comorbidities. Aim of this narrative review is to provide an update on recent studies, with special attention to cardiovascular and cerebrovascular comorbidities, the metabolic syndrome and type 2 diabetes, asthma, COPD and cancer. Better phenotypic characterization of OSA patients, including comorbidities, will help to provide better individualized care. The unsatisfactory adherence to CPAP in patients without daytime sleepiness should prompt clinicians to examine the overall risk profile of each patient in order to identify subjects at high risk for worse prognosis and provide the optimal treatment not only for OSA, but also for comorbidities.

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Effect of continuous positive airway pressure on albuminuria in patients with obstructive sleep apnea: a meta-analysis

Chen¹,

Huang

Lin

et al. 2021

Sleep Breath

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Effect of Sleep-Disordered Breathing on Albuminuria in 273 Patients With Type 2 Diabetes

Abstract: The severity of SDB is associated with albuminuria in patients with T2DM.

Cited by 17 publications

References 39 publications

Association of diabetic nephropathy with the severity of obstructive sleep apnea-hypopnea syndrome in patients with type 2 diabetes mellitus

Association of diabetic nephropathy with the severity of obstructive sleep apnea-hypopnea syndrome in patients with type 2 diabetes mellitus

Obstructive sleep apnea and comorbidities: a dangerous liaison

Effect of continuous positive airway pressure on albuminuria in patients with obstructive sleep apnea: a meta-analysis

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