Independent association between obstructive sleep apnea severity and glycated hemoglobin in adults without diabetes

摘要

OBJECTIVE - We tested the hypothesis of an independent cross-sectional association between obstructive sleep apnea (OSA) severity and glycated hemoglobin (HbA 1c) in adults without known diabetes. RESEARCH DESIGN AND METHODS - HbA 1c was measured in whole-blood samples from 2,139 patients undergoing nocturnal recording for suspected OSA. Participants with selfreported diabetes, use of diabetes medication, or HbA 1c value ≥6.5% were excluded from this study. Our final sample size comprised 1,599 patients. RESULTS - A dose-response relationship was observed between apnea-hypopnea index (AHI) and the percentage of patients with HbA 1c 6.0%, ranging from 10.8%for AHI 5 to 34.2% for AHI ≥50. After adjustment for age, sex, smoking habits, BMI, waist circumference, cardiovascular morbidity, daytime sleepiness, depression, insomnia, sleep duration, and study site, odds ratios (95% CIs) for HbA 1c ≥6.0% were 1 (reference), 1.40 (0.84-2.32), 1.80 (1.19-2.72), 2.02 (1.31-3.14), and 2.96 (1.58-5.54) for AHI values 5, 5 to 15, 15 to 30, 30 to 50, and $50, respectively. Increasing hypoxemia during sleep was also independently associated with the odds of HbA 1c 6.0%. CONCLUSIONS - Among adults without known diabetes, increasing OSA severity is independently associated with impaired glucose metabolism, as assessed by higher HbA 1c values, which may expose them to higher risks of diabetes and cardiovascular disease.