0
Original Research: Sleep Disorders |

Sleep Apnea and Glucose MetabolismA Longitudinal Study on Sleep Apnea and Diabetes: A Long-term Follow-up in a Community-Based Sample

Eva Lindberg, MD, PhD; Jenny Theorell-Haglöw, PhD; Malin Svensson, MD, PhD; Thorarinn Gislason, MD, PhD; Christian Berne, MD, PhD; Christer Janson, MD, PhD
Author and Funding Information

From the Department of Medical Sciences (Drs Lindberg, Theorell-Haglöw, and Janson), Respiratory Medicine and Allergology; Department of Surgical Sciences (Dr Svensson), Otorhinolaryngology; and Department of Medical Sciences (Dr Berne), Internal Medicine, Uppsala University, Uppsala, Sweden; and Department of Respiratory Medicine and Sleep (Dr Gislason), University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland.

Correspondence to: Eva Lindberg, MD, PhD, Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Akademiska sjukhuset, SE-751 85 Uppsala, Sweden; e-mail: eva.lindberg@medsci.uu.se


Funding/Support: The study was funded by the Swedish Heart Lung Foundation and the Uppsala County Association against Heart and Lung Diseases.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(4):935-942. doi:10.1378/chest.11-1844
Text Size: A A A
Published online

Background:  It has been suggested that sleep-disordered breathing (SDB) is a risk factor for diabetes, but long-term follow-up studies are lacking. The aim of this community-based study was to analyze the influence of SDB on glucose metabolism after > 10 years.

Methods:  Men without diabetes (N = 141; mean age, 57.5 years) were investigated at baseline, including whole-night respiratory monitoring. After a mean period of 11 years and 4 months, they were followed up with an interview, anthropometric measurements, and blood sampling. Insulin resistance was quantified using the homeostasis model assessment of insulin resistance (HOMA-IR). ΔHOMA-IR was calculated as (HOMA-IR at follow-up − HOMA-IR at baseline). An oral glucose tolerance test was performed on 113 men to calculate the insulin sensitivity index.

Results:  The mean apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) at baseline were 4.7 and 3.3, respectively. At follow-up, 23 men had diabetes. An ODI > 5 was a predictor of developing diabetes (OR, 4.4; 95% CI, 1.1-18.1, after adjusting for age, BMI, and hypertension at baseline and ΔBMI and years with CPAP during follow-up). The ODI was inversely related to the insulin sensitivity index at follow-up (r = −0.27, P = .003). A deterioration in HOMA-IR was significantly related to all variables of SDB (AHI, AHI > 5; ODI, ODI > 5; minimum arterial oxygen saturation), even when adjusting for confounders. When excluding the variable years with CPAP from the multivariate model, all associations weakened.

Conclusions:  SDB is independently related to the development of insulin resistance and, thereby, the risk of manifest diabetes mellitus.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543