Diabetes Care:阻塞性睡眠呼吸暂停是2型糖尿病患者心血管和微血管疾病的危险因素

2020-04-29 MedSci原创 MedSci原创

与不伴有OSA的患者相比,伴有OSA的2型糖尿病患者发生CVD、AF、PN、DFD、CKD和全因死亡增加。伴有OSA的2型糖尿病患者属于高危人群,应针对OSA进行筛查以预防心血管和微血管并发症。

近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员旨在明确与没有诊断阻塞性睡眠呼吸暂停(OSA)的2型糖尿病患者相比,随后发生OSA的2型糖尿病患者心血管疾病(CVD)、微血管并发症和死亡风险。

这项年龄、性别、BMI和糖尿病患病时间匹配的队列研究使用了英国初级保健数据库中2005年1月1日至2018年1月17日的数据。该研究纳入了年龄超过16岁的2型糖尿病患者。暴露的参与者是那些在糖尿病诊断后患上OSA的患者;未暴露的参与者是那些未患OSA的参与者。该研究的结局是CVD复合事件(缺血性心脏病[IHD]、卒中/短暂性脑缺血发作[TIA]、心力衰竭[HF])、外周血管疾病(PVD)、房颤(AF)、周围神经病(PN)、糖尿病相关足部疾病(DFD)、视网膜病变、慢性肾脏疾病(CKD)和全因死亡率。研究人员对2型糖尿病诊断前患有OSA的患者和无OSA的糖尿病患者也进行了同样的分析。

该研究总共纳入了3667位暴露的参与者和10450位匹配的对照参与者。调整后的结局风险比如下:CVD复合事件为1.54(95%CI为1.32,1.79),IHD为1.55(1.26,1.90),HF为1.67(1.35,2.06),卒中/TIA为1.57(1.27,1.94),PVD为1.10 (0.91,1.32),AF为1.53(1.28,1.83),PN为1.32(1.14,1.51),DFD为1.42(1.16,1.74),视网膜病变为0.99(0.82,1.21),CKD(3-5期)为1.18(1.02, 1.36),白蛋白尿为1.11(1.01,1.22)和全因死亡率为1.24(1.10,1.40)。在OSA队列中,结果相似,但是未观察到存在关联。

由此可见,与不伴有OSA的患者相比,伴有OSA的2型糖尿病患者发生CVD、AF、PN、DFD、CKD和全因死亡增加。伴有OSA的2型糖尿病患者属于高危人群,应针对OSA进行筛查以预防心血管和微血管并发症。

原始出处:

Nicola J. Adderley,et al.Obstructive Sleep Apnea, a Risk Factor for Cardiovascular and Microvascular Disease in Patients With Type 2 Diabetes: Findings From a Population-Based Cohort Study.Diabetes Care.2020.https://doi.org/10.2337/dc19-2116

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    2020-10-07 tomyang96
  4. 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12:51:03 CST 2020, time=2020-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596596, encodeId=ec94159659673, content=<a href='/topic/show?id=70e4396491a' target=_blank style='color:#2F92EE;'>#呼吸暂停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Fri May 01 12:51:03 CST 2020, time=2020-05-01, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1902426, encodeId=506b1902426c1, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Sun Mar 07 01:51:03 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1639456, encodeId=5a851639456ce, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, 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12:51:03 CST 2020, time=2020-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596596, encodeId=ec94159659673, content=<a href='/topic/show?id=70e4396491a' target=_blank style='color:#2F92EE;'>#呼吸暂停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Fri May 01 12:51:03 CST 2020, time=2020-05-01, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1902426, encodeId=506b1902426c1, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Sun Mar 07 01:51:03 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1639456, encodeId=5a851639456ce, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, 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encodeId=cdc114e49234a, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Fri May 01 12:51:03 CST 2020, time=2020-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498722, encodeId=363b1498e22c1, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri May 01 12:51:03 CST 2020, time=2020-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596596, encodeId=ec94159659673, content=<a href='/topic/show?id=70e4396491a' target=_blank style='color:#2F92EE;'>#呼吸暂停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Fri May 01 12:51:03 CST 2020, time=2020-05-01, status=1, ipAttribution=)]
    2020-05-01 mgqwxj
  7. 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