Obstructive sleep apnea and incident type 2 diabetes

Abstract

Objectives To determine whether severity of obstructive sleep apnea is associated with incident diabetes in middle-aged and older adults. Methods A prospective analysis of 1,453 non-diabetic participants of both the Atherosclerosis Risk in Communities Study and the Sleep Heart Health Study (mean age 63 years, 46% male) had in-home polysomnography (1996–1998) and were followed for incident diabetes. Using the apnea-hypopnea index derived from home polysomnography, study participants were categorized as follows: <5.0 (normal), 5.0–14.9 (mild), 15.0–29.9 (moderate), and ≥30.0 events/h (severe). Incident diabetes was ascertained during annual follow-up telephone calls through 2013. Results During a median follow-up of 13 years, there were 285 incident diabetes cases among the 1453 participants. Participants with severe obstructive sleep apnea were at greater risk of incident diabetes compared to persons classified as normal after adjustment for confounders including body mass index and waist circumference (1.71 [1.08, 2.71]). The association between severe obstructive sleep apnea and incident diabetes was similar when analyses were restricted to obese individuals. Conclusions Severe obstructive sleep apnea was associated with greater risk of incident diabetes, independent of adiposity in a community-based sample. Healthcare professionals should be cognizant of the high prevalence of OSA in the general population and the potential link to incident diabetes.

C-reactive protein improves the ability to detect cardiometabolic risk in mild-to-moderate obstructive sleep apnea

“…Our findings are corroborated by a recent study suggesting that CRP levels partially mediate the association between AHI and incident type 2 diabetes (Nagayoshi et al. ). Another recent paper demonstrated that inflammation was associated with objectively measured daytime sleepiness in patients with OSA, but not with subjectively measured sleepiness, suggesting a link between inflammation and underlying subclinical cardiometabolic dysfunction in OSA (Li et al.…”

“…A more recent study demonstrated that CRP appears to mediate the association between AHI and incident type 2 diabetes (Nagayoshi et al. ), suggesting its potential efficacy in discriminating which patients with OSA may have a worse prognosis.…”

Modifiable Lifestyle Risk Factors and Incident Diabetes in African Americans

“…8,19,31 Consistent with the SDBB findings, obstructive sleep apnea has been linked with incident diabetes in a study including AAs. 32 In this study, the individual effect of each modifiable lifestyle risk factor on diabetes incidence was non-significant but in the expected direction, though this was attenuated after accounting for BMI. These results differ from larger analyses of NHWs in which ideal dietary intake, 33 higher physical activity, 19 sleep disordered breathing, 34,35 and smoking 36 were individually associated with a lower risk of developing diabetes.…”

New Insight into the Role of Obstructive Sleep Apnea in Cardiometabolic Diseases

“…In an independent manner regarding the volume of the adipose tissue, the severe form of OSA is associated with a higher risk in the case of unknown diabetes [28]. The presence of OSA should be screened in adults with type 2 diabetes, especially in males with obesity and history of heavy snoring and daytime sleepiness [29].…”