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Diabetes Is an Independent Risk Factor for Severe Nocturnal Hypoxemia in Obese Patients. A Case-Control Study

BACKGROUND: Type 2 diabetes mellitus (T2DM) and obesity have become two of the main threats to public health in the Western world. In addition, obesity is the most important determinant of the sleep apnea-hypopnea syndrome (SAHS), a condition that adversely affects glucose metabolism. However, it is...

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Autores principales: Lecube, Albert, Sampol, Gabriel, Lloberes, Patricia, Romero, Odile, Mesa, Jordi, Hernández, Cristina, Simó, Rafael
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2650786/
https://www.ncbi.nlm.nih.gov/pubmed/19262746
http://dx.doi.org/10.1371/journal.pone.0004692
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author Lecube, Albert
Sampol, Gabriel
Lloberes, Patricia
Romero, Odile
Mesa, Jordi
Hernández, Cristina
Simó, Rafael
author_facet Lecube, Albert
Sampol, Gabriel
Lloberes, Patricia
Romero, Odile
Mesa, Jordi
Hernández, Cristina
Simó, Rafael
author_sort Lecube, Albert
collection PubMed
description BACKGROUND: Type 2 diabetes mellitus (T2DM) and obesity have become two of the main threats to public health in the Western world. In addition, obesity is the most important determinant of the sleep apnea-hypopnea syndrome (SAHS), a condition that adversely affects glucose metabolism. However, it is unknown whether patients with diabetes have more severe SAHS than non-diabetic subjects. The aim of this cross-sectional case-control study was to evaluate whether obese patients with T2DM are more prone to severe SAHS than obese non-diabetic subjects. METHODOLOGY/PRINCIPAL FINDINGS: Thirty obese T2DM and 60 non-diabetic women closely matched by age, body mass index, waist circumference, and smoking status were recruited from the outpatient Obesity Unit of a university hospital. The exclusion criteria included chronic respiratory disease, smoking habit, neuromuscular and cerebrovascular disease, alcohol abuse, use of sedatives, and pregnancy. Examinations included a non-attended respiratory polygraphy, pulmonary function testing, and an awake arterial gasometry. Oxygen saturation measures included the percentage of time spent at saturations below 90% (CT90). A high prevalence of SAHS was found in both groups (T2DM:80%, nondiabetic:78.3%). No differences in the number of sleep apnea-hypopnea events between diabetic and non-diabetic patients were observed. However, in diabetic patients, a significantly increase in the CT90 was detected (20.2±30.2% vs. 6.8±13,5%; p = 0.027). In addition, residual volume (RV) was significantly higher in T2DM (percentage of predicted: 79.7±18.1 vs. 100.1±22.8; p<0.001). Multiple linear regression analyses showed that T2DM but not RV was independently associated with CT90. CONCLUSIONS/SIGNIFICANCE: T2DM adversely affects breathing during sleep, becoming an independent risk factor for severe nocturnal hypoxemia in obese patients. Given that SAHS is a risk factor of cardiovascular disease, the screening for SAHS in T2DM patients seems mandatory.
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spelling pubmed-26507862009-03-05 Diabetes Is an Independent Risk Factor for Severe Nocturnal Hypoxemia in Obese Patients. A Case-Control Study Lecube, Albert Sampol, Gabriel Lloberes, Patricia Romero, Odile Mesa, Jordi Hernández, Cristina Simó, Rafael PLoS One Research Article BACKGROUND: Type 2 diabetes mellitus (T2DM) and obesity have become two of the main threats to public health in the Western world. In addition, obesity is the most important determinant of the sleep apnea-hypopnea syndrome (SAHS), a condition that adversely affects glucose metabolism. However, it is unknown whether patients with diabetes have more severe SAHS than non-diabetic subjects. The aim of this cross-sectional case-control study was to evaluate whether obese patients with T2DM are more prone to severe SAHS than obese non-diabetic subjects. METHODOLOGY/PRINCIPAL FINDINGS: Thirty obese T2DM and 60 non-diabetic women closely matched by age, body mass index, waist circumference, and smoking status were recruited from the outpatient Obesity Unit of a university hospital. The exclusion criteria included chronic respiratory disease, smoking habit, neuromuscular and cerebrovascular disease, alcohol abuse, use of sedatives, and pregnancy. Examinations included a non-attended respiratory polygraphy, pulmonary function testing, and an awake arterial gasometry. Oxygen saturation measures included the percentage of time spent at saturations below 90% (CT90). A high prevalence of SAHS was found in both groups (T2DM:80%, nondiabetic:78.3%). No differences in the number of sleep apnea-hypopnea events between diabetic and non-diabetic patients were observed. However, in diabetic patients, a significantly increase in the CT90 was detected (20.2±30.2% vs. 6.8±13,5%; p = 0.027). In addition, residual volume (RV) was significantly higher in T2DM (percentage of predicted: 79.7±18.1 vs. 100.1±22.8; p<0.001). Multiple linear regression analyses showed that T2DM but not RV was independently associated with CT90. CONCLUSIONS/SIGNIFICANCE: T2DM adversely affects breathing during sleep, becoming an independent risk factor for severe nocturnal hypoxemia in obese patients. Given that SAHS is a risk factor of cardiovascular disease, the screening for SAHS in T2DM patients seems mandatory. Public Library of Science 2009-03-05 /pmc/articles/PMC2650786/ /pubmed/19262746 http://dx.doi.org/10.1371/journal.pone.0004692 Text en Lecube et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Lecube, Albert
Sampol, Gabriel
Lloberes, Patricia
Romero, Odile
Mesa, Jordi
Hernández, Cristina
Simó, Rafael
Diabetes Is an Independent Risk Factor for Severe Nocturnal Hypoxemia in Obese Patients. A Case-Control Study
title Diabetes Is an Independent Risk Factor for Severe Nocturnal Hypoxemia in Obese Patients. A Case-Control Study
title_full Diabetes Is an Independent Risk Factor for Severe Nocturnal Hypoxemia in Obese Patients. A Case-Control Study
title_fullStr Diabetes Is an Independent Risk Factor for Severe Nocturnal Hypoxemia in Obese Patients. A Case-Control Study
title_full_unstemmed Diabetes Is an Independent Risk Factor for Severe Nocturnal Hypoxemia in Obese Patients. A Case-Control Study
title_short Diabetes Is an Independent Risk Factor for Severe Nocturnal Hypoxemia in Obese Patients. A Case-Control Study
title_sort diabetes is an independent risk factor for severe nocturnal hypoxemia in obese patients. a case-control study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2650786/
https://www.ncbi.nlm.nih.gov/pubmed/19262746
http://dx.doi.org/10.1371/journal.pone.0004692
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