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由北京大学人民医院纪立农教授团队完成的一项研究显示，中国2型糖尿病（T2DM）住院患者阻塞性睡眠呼吸暂停（OSA）的患病率高达61.5%，且OSA与糖尿病肾病和卒中相关。该研究摘要6月15日在第74上发布。届美国糖尿病协会科学年会（ADA2014）
本研究的目的是评估2型糖尿病（T2DM）住院患者中阻塞性睡眠呼吸暂停（OSA）的患病率及相关危险因素。
中国12家医院的2型糖尿病患者参加了这项研究。1016例符合条件的患者进行连续登记，884例患者同意参加本研究并完成了睡眠监测。采用单声道录音装置检测是否患有OSA。记录夜间呼吸暂停低通气指数（AHI）以评估OSA的严重程度。OSA定义为排除中枢性阻塞性呼吸暂停（CSA）后，AHI≥5次/h。采用单因素和多因素回归分析估计OSA和糖尿病并发症之间的相关性。
OSA的患病率为61.5％。中度/重度OSA（AHI≥15次/h）的患病率为26.2％。中位AHI为7次/h，四分位距为2次/h-15次/h。研究发现OSA的严重程度与糖尿病肾病分期和卒中显著，单因素分析未发现OSA和糖尿病外周神经病变、视网膜病变或冠状动脉心脏疾病之间存在相关性。在调整了年龄和性别后，OSA的严重程度仍然与糖尿病肾病分期（多因素logistic回归OR=1.18，95%CI：1.03-1.34，p=0.015）独立相关，AHI与血清肌酸（b=0.25，p=0.040）和微量白蛋白尿（b=3.49，p=0.024）线性相关。
本研究发现2型糖尿病住院患者OSA患病率高。OSA与糖尿病肾病和卒中相关。
【研究摘要】
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Abstract Number:
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2526-PO
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Title:
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Prevalence and Associated Factors of Obstructive Sleep Apnea in Hospitalized Patients with Type 2 Diabetes in China（中国2型糖尿病住院患者阻塞性睡眠呼吸暂停的患病率及相关因素）
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Authors:
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RUI ZHANG, LINONG JI, PUHONG ZHANG, Beijing, China
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Abstract:
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To assess the prevalence and risk factors associated with the presence of obstructive sleep apnea (OSA) in hospitalized patients with type 2 diabetes (T2DM).
Patients with T2DM in twelve hospitals of China were invited to attend the study. 1016 eligible patients were consecutively registered and 884 agreed to participate and completed the sleep monitoring. A single-channel recording device was used to detect the presence of OSA. Apnea-hypopnea index (AHI) during night were recorded to evaluate the severity of OSA. OSA was defined as AHI ≥ 5/h after excluding central obstructive apnea (CSA). Univariate and multivariate regression analysis were used to estimate correlation between OSA and diabetes complications.
The prevalence of OSA was 61.5%. The prevalence of moderate/severe OSA (AHI ≥ 15/h) was 26.2%. The median AHI was 7/h, with interquartile of 2/h-15/h. We found OSA severity was associated significantly with diabetic nephropathy stage and stroke, while the correlation between OSA and diabetes peripheral Neuropathy, retinopathy and coronary heart disease were not found in univariate analysis. After adjustment for age and gender, OSA severity remained independently associated with diabetic nephropathy stage (Multi-logistic regression: OR=1.18; 95%CI 1.03-1.34, p=0.015) and AHI is linear associated with serum creatine (b=0.25, p=0.040) and microalbuminuria (b=3.49, p=0.024).
A high prevalence of OSA was present in this study. OSA was found correlated with diabetic nephropathy and stroke.
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