Independent Association Between Obstructive Sleep Apnea Severity and Glycated Hemoglobin

in Adults Without Diabetes

Featured Article:

Pascaline Priou, M.D., Marc Le Vaillant, Ph.D., Nicole Meslier, M.D., Sylvaine Chollet, M.D., Philippe Masson, M.D., Marie P. Humeau, M.D., Thierry Pigeanne, M.D., Acya Bizieux-Thaminy, M.D., François Goupil, M.D., Frédéric Gagnadoux, M.D., Ph.D., The IRSR Sleep Cohort Group

Diabetes Care Volume 35: 1902-1906

September, 2012

Study Objective

• To test the hypothesis of an independent cross-sectional association between obstructive sleep apnea (OSA) severity and glycated hemoglobin (HbA1c) in adults without known diabetes

Priou P et al. Diabetes Care 2012;35:1902-1906

Study Design & Methods

• HbA1c measured in whole-blood samples from 2,139 patients undergoing nocturnal recording for suspected OSA

• Participants with self-reported diabetes, use of diabetes medication, or HbA1c value ≥6.5% excluded from study

• Final sample size comprised 1,599 patients

Priou P et al. Diabetes Care 2012;35:1902-1906

Results

• Dose-response relationship observed between apnea-hypopnea index (AHI) and the percentage of patients with HbA1c >6.0%, ranging from 10.8% for AHI <5 to 34.2% for AHI ≥50

• After adjusting for age, sex, smoking habits, BMI, waist circumference, cardiovascular morbidity, daytime sleepiness, depression, insomnia, sleep duration, and study site, odds ratios (95% CIs) for HbA1c >6.0% were as follows:

o 1 (reference) for AHI values <5o 1.40 (0.84–2.32) for values 5 to <15o 1.80 (1.19–2.72) for values 15 to <30o 2.02 (1.31–3.14) for values 30 to <50o 2.96 (1.58–5.54) for values ≥50

• Increasing hypoxemia during sleep was independently associated with the odds of HbA1c >6.0%

Priou P et al. Diabetes Care 2012;35:1902-1906

Priou P et al. Diabetes Care 2012;35:1902-1906

Priou P et al. Diabetes Care 2012;35:1902-1906

Priou P et al. Diabetes Care 2012;35:1902-1906

Conclusions

• In adults without known diabetes, increasing OSA severity independently associated with impaired glucose metabolism, as assessed by higher HbA1c values

• Impaired glucose metabolism may expose adults to a higher risk of diabetes and cardiovascular disease

Priou P et al. Diabetes Care 2012;35:1902-1906