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Article: Prevalence and recognition of obstructive sleep apnea in Chinese patients with type 2 diabetes mellitus
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TitlePrevalence and recognition of obstructive sleep apnea in Chinese patients with type 2 diabetes mellitus
 
AuthorsLam, DCL1
Lui, MMS1
Lam, JCM1
Ong, LHY1
Lam, KSL1
Ip, MSM1
 
Issue Date2010
 
PublisherAmerican College of Chest Physicians. The Journal's web site is located at http://www.chestjournal.org
 
CitationChest, 2010, v. 138 n. 5, p. 1101-1107 [How to Cite?]
DOI: http://dx.doi.org/10.1378/chest.10-0596
 
AbstractBackground: Obstructive sleep apnea (OSA) is associated with disorders of glucose metabolism. Previous studies revealed a high prevalence of OSA among subjects with type 2 diabetes mellitus (DM). The aims of this study were to determine the prevalence of OSA and associated clinical factors in Chinese patients with DM. Methods: All records of the DM clinic at a teaching hospital in Hong Kong were screened between January 2007 and June 2008. Inclusion criteria for patients were Chinese, aged 18 to 75 years, with type 2 DM. Patients with unstable medical illnesses, gestational diabetes, or on renal replacement therapy were excluded. Results: Of 3,489 records screened, 1,859 subjects were eligible. A random sample of 663 (mean age, 58.2 ± 10.8; mean BMI, 26.0 ± 4.6), except six with known OSA, were invited for polysomnography (PSG). Of 165 subjects on which PSG was performed, OSA was diagnosed (apnea-hypopnea index [AHI] ≥ 5.0/h) in 89 subjects (53.9%, median Epworth Sleepiness Scale, 6 [interquartile range 3, 10]). Fifty-four (32.7%) had moderate/severe OSA (AHI ≥ 15/h). The estimated OSA prevalence in this diabetic cohort was 17.5% (24.7% in men, 10.3% in women). Regression analysis identified that AHI was associated independently with higher BMI, advanced age, male sex, and higher diastolic BP (R2 = 29.6%). The adjusted OR of requiring three or more antihypertensive drugs in moderate/severe OSA was 2.48 (95% CI, 1.05-5.87). No association between glycemic control (HbA1c) and sleep was identified. Conclusions: In conclusion, OSA is more prevalent in Chinese adults with DM than in the general population. A high index of suspicion for OSA in patients with DM is warranted, because they may not have overt daytime sleepiness. Trial registry: ClinicalTrials.gov; No.: NCT01172093; URL: www.clinicaltrials.gov. © 2010 American College of Chest Physicians.
 
ISSN0012-3692
2012 Impact Factor: 5.854
2012 SCImago Journal Rankings: 2.031
 
DOIhttp://dx.doi.org/10.1378/chest.10-0596
 
ISI Accession Number IDWOS:000284341700016
Funding AgencyGrant Number
University of Hong Kong
Boehringer Inc
Roche
GlaxoSmithKline
ResMed
Celki
Boehringer Ingelheim
Hong Kong Research Grant Council
Boehringer/Pfizer
Respironics
Funding Information:

This study was supported by the Sleep and Respiratory Fund, University of Hong Kong.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLam, DCL
 
dc.contributor.authorLui, MMS
 
dc.contributor.authorLam, JCM
 
dc.contributor.authorOng, LHY
 
dc.contributor.authorLam, KSL
 
dc.contributor.authorIp, MSM
 
dc.date.accessioned2011-09-23T05:50:19Z
 
dc.date.available2011-09-23T05:50:19Z
 
dc.date.issued2010
 
dc.description.abstractBackground: Obstructive sleep apnea (OSA) is associated with disorders of glucose metabolism. Previous studies revealed a high prevalence of OSA among subjects with type 2 diabetes mellitus (DM). The aims of this study were to determine the prevalence of OSA and associated clinical factors in Chinese patients with DM. Methods: All records of the DM clinic at a teaching hospital in Hong Kong were screened between January 2007 and June 2008. Inclusion criteria for patients were Chinese, aged 18 to 75 years, with type 2 DM. Patients with unstable medical illnesses, gestational diabetes, or on renal replacement therapy were excluded. Results: Of 3,489 records screened, 1,859 subjects were eligible. A random sample of 663 (mean age, 58.2 ± 10.8; mean BMI, 26.0 ± 4.6), except six with known OSA, were invited for polysomnography (PSG). Of 165 subjects on which PSG was performed, OSA was diagnosed (apnea-hypopnea index [AHI] ≥ 5.0/h) in 89 subjects (53.9%, median Epworth Sleepiness Scale, 6 [interquartile range 3, 10]). Fifty-four (32.7%) had moderate/severe OSA (AHI ≥ 15/h). The estimated OSA prevalence in this diabetic cohort was 17.5% (24.7% in men, 10.3% in women). Regression analysis identified that AHI was associated independently with higher BMI, advanced age, male sex, and higher diastolic BP (R2 = 29.6%). The adjusted OR of requiring three or more antihypertensive drugs in moderate/severe OSA was 2.48 (95% CI, 1.05-5.87). No association between glycemic control (HbA1c) and sleep was identified. Conclusions: In conclusion, OSA is more prevalent in Chinese adults with DM than in the general population. A high index of suspicion for OSA in patients with DM is warranted, because they may not have overt daytime sleepiness. Trial registry: ClinicalTrials.gov; No.: NCT01172093; URL: www.clinicaltrials.gov. © 2010 American College of Chest Physicians.
 
dc.description.naturelink_to_OA_fulltext
 
dc.identifier.citationChest, 2010, v. 138 n. 5, p. 1101-1107 [How to Cite?]
DOI: http://dx.doi.org/10.1378/chest.10-0596
 
dc.identifier.doihttp://dx.doi.org/10.1378/chest.10-0596
 
dc.identifier.epage1107
 
dc.identifier.hkuros194078
 
dc.identifier.isiWOS:000284341700016
Funding AgencyGrant Number
University of Hong Kong
Boehringer Inc
Roche
GlaxoSmithKline
ResMed
Celki
Boehringer Ingelheim
Hong Kong Research Grant Council
Boehringer/Pfizer
Respironics
Funding Information:

This study was supported by the Sleep and Respiratory Fund, University of Hong Kong.

 
dc.identifier.issn0012-3692
2012 Impact Factor: 5.854
2012 SCImago Journal Rankings: 2.031
 
dc.identifier.issue5
 
dc.identifier.pmid20705796
 
dc.identifier.scopuseid_2-s2.0-78349303457
 
dc.identifier.spage1101
 
dc.identifier.urihttp://hdl.handle.net/10722/139459
 
dc.identifier.volume138
 
dc.languageeng
 
dc.publisherAmerican College of Chest Physicians. The Journal's web site is located at http://www.chestjournal.org
 
dc.publisher.placeUnited States
 
dc.relation.ispartofChest
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshBlood Glucose - metabolism
 
dc.subject.meshDiabetes Mellitus, Type 2 - blood - complications - epidemiology
 
dc.subject.meshHong Kong - epidemiology
 
dc.subject.meshPolysomnography - methods
 
dc.subject.meshSleep Apnea, Obstructive - diagnosis - epidemiology - etiology
 
dc.titlePrevalence and recognition of obstructive sleep apnea in Chinese patients with type 2 diabetes mellitus
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong