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Type: Journal article
Title: Nocturnal hypoxemia and severe obstructive sleep apnea are associated with incident type 2 diabetes in a population cohort of men
Author: Appleton, S.L.
Vakulin, A.
McEvoy, R.D.
Wittert, G.A.
Martin, S.A.
Grant, J.F.
Taylor, A.W.
Antic, N.A.
Catcheside, P.G.
Adams, R.J.
Citation: The Journal of Clinical Sleep Medicine, 2015; 11(6):609-609
Publisher: American Academy of Sleep Medicine
Issue Date: 2015
ISSN: 1550-9389
Statement of
Sarah L. Appleton, Andrew Vakulin, R. Doug McEvoy, Gary A. Wittert, Sean A. Martin, Janet F. Grant, Anne W. Taylor, Nick A. Antic, Peter G. Catcheside, Robert J. Adams
Abstract: <h4>Study objectives</h4>Studies examining the longitudinal association of untreated obstructive sleep apnea (OSA) with diabetes in population samples are limited. This study therefore examined the relationship between previously undiagnosed OSA with incident type 2 diabetes in community-dwelling men aged ≥ 40 y.<h4>Methods</h4>The Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) Study is a longitudinal population-based cohort in Adelaide, South Australia. Clinic assessments at baseline and follow-up identified diabetes (self-reported doctor diagnosed, fasting plasma glucose ≥ 7.0 mmol/L, glycated hemoglobin ≥ 6.5% or diabetes medication use) and included anthropometry. At cohort follow-up (2010-2012), n = 837 underwent full in-home unattended polysomnography (PSG, Embletta X100, Broomfield, CO).<h4>Results</h4>Of 736 men free of diabetes at baseline, incident diabetes occurred in 66 (9.0%) over a mean follow-up time of 56 mo (standard deviation = 5, range: 48-74 mo). Incident diabetes was associated with current oxygen desaturation index (3%) ≥ 16 events/h (odds ratio [OR]: 1.85 [1.06-3.21]), and severe OSA [OR: 2.6 (1.1-6.1)], in adjusted models including age, percentage total body fat, and weight gain (> 5 cm waist circumference). An age-adjusted association of incident diabetes with percentage of total sleep time with oxygen saturation < 90% did not persist after adjustment for percentage of body fat. No modification of these relationships by excessive daytime sleepiness was observed.<h4>Conclusions</h4>Severe undiagnosed OSA and nocturnal hypoxemia were independently associated with the development of diabetes. A reduction in the burden of undiagnosed OSA and undiagnosed diabetes is likely to occur if patients presenting with one disorder are assessed for the other.
Keywords: Humans
Sleep Apnea, Obstructive
Diabetes Mellitus, Type 2
Odds Ratio
Risk Factors
Cohort Studies
Longitudinal Studies
Follow-Up Studies
Middle Aged
South Australia
Description: Currently embargoed: Free in PMC on Dec 15, 2015
Rights: Copyright status unknown
DOI: 10.5664/jcsm.4768
Grant ID: ARC
Published version:
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