Type 2 Diabetes and Pre-Diabetes Associated With OSA Among Obese

Sunday, September 25th, 2011 at 11:26 PM

Obstructive sleep apnea (OSA) is a common yet underdiagnosed condition. The aim of our study is to test whether prediabetes and type 2 diabetes are associated with obstructive sleep apnea (OSA) in extremely obese (BMI [greater than or equal to] 40 kg/m2) subjects.

One hundred and thirty seven consecutive extremely obese patients (99 females) from a controlled clinical trial [MOBIL-study (Morbid Obesity treatment, Bariatric surgery versus Intensive Lifestyle intervention Study) (ClinicalTrials.gov number NCT00273104)] underwent somnography with Embletta(R) and a 2-hour oral glucose tolerance test (OGTT).

OSA was defined by an apnea-hypopnea index (AHI) [greater than or equal to] 5 events/hour. Patients were categorized into three groups according to criteria from the American Diabetes Association: normal glucose tolerance, pre-diabetes and type 2 diabetes.

Multiple logistic regression analysis was used to identify possible determinants of OSA.

The patients had a mean (SD) age of 43 (11) years and a body mass index (BMI) of 46.9 (5.7) kg/m2. Males had significantly higher AHI than females, 29 (25) vs 12 (17) events/hour, p<0.001.

OSA was observed in 81 % of men and in 55 % of women, p=0.008. Twenty-nine percent of subjects had normal glucose tolerance, 42 % had pre-diabetes and 29 % had type 2 diabetes.

Among the patients with normal glucose tolerance 33 % had OSA, while 67 % of the pre-diabetic patients and 78 % of the type 2 diabetic patients had OSA, p<0.001. After adjusting for age, gender, BMI, high sensitive CRP and HOMA-IR, both pre-diabetes and type 2 diabetes were still associated with OSA, odds ratios 3.18 (95 % CI 1.00, 10.07), p=0.049 and 4.17 (1.09, 15.88), p=0.036, respectively.

Mean serum leptin was significantly lower in the OSA than in the non-OSA group, while other measures of inflammation did not differ significantly between groups.

Type 2 diabetes and pre-diabetes are associated with OSA in extremely obese subjects.

Source: Cardiovascular Diabetology 2011, 10:84