Cardiovascular risk and sleep apnea risk in people with type 2 diabetes
DOI:
https://doi.org/10.52556/2587-3873.2024.5(102).08Keywords:
type 2 diabetes, Sleep apnea syndrome, cardiovascularrisk, SCORE-2 diabetesAbstract
The global pandemic of metabolic diseases commonly associated with sleep apnea is a major risk factor for cardiovascular disease mortality. Accordingly, risk stratification for sleep apnea syndrome in all patients with diabetes is essential. The descriptive study included 150 patients with DM type 2, hospitalized in the Endocrinology department of the „Timofei Moșneaga” Republican Clinical Hospital between September and November 2023. The STOP-BANG questionnaire was used for risk stratification for SAS, and for cardiovascular risk - the system SCORE 2-Diabetes. It is determined that 44% of patients DM2 are at intermediate risk for SAS, 34% of them are at high risk and only 22% are at low risk. And according to the SCORE 2-diabetes system: 0.7% of patients with DM type 2 present a low risk; 6,7% moderate risk; 21,3% high risk and 71,3% very high risk. Most patients with type 2 DM present intermediate and high risk for SAS, as well as very high risk for cardiovascular events. And overweight reported by BMI and CA is higher among patients with type 2 DM and high risk for SAS. Additionally, it is noted that most patients with high and very high CV risk are at increased risk for SAS.
References
1. ADDERLEY N., SUBRAMANIAN A., TOULIS K., 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. In: Diabetes Care. 2020, Vol. 43, nr. 8, pp. 1868-1877. PMID: 32345651 https://doi.org/10.2337/dc19-2116
2. ALASTAIR G., DANIEL P., INGRID D., et al. Rezistența la insulină adipoasă se asociază cu dislipidemie independentă de rezistența hepatică și implică sem nalizarea hormonală timpurie. În: AHAIASA Journals.2024, Vol. 43, nr. 6, pp.1054-1065. ISSN 1079-5642
3. BECK M., WESTERGAARD D., JENSEN A., et al. Temporal order of disease pairs affects subsequent disease trajectories: the case of diabetes and sleep apnea. In: Pacific Symposium Biocomputing. 2017; Vol. 22; pp. 380-389. PMID: 27896991 https://doi.org/10.1142/9789813207813_0036
4. BOTNARU V., CORLĂTEANU A., SÎRCU V., et al. Sindromul de apnee obstructivă în somn. Protocol clinic național. 2017.
5. CIPOLLA-NETO J., GASPAR DO AMARAL F. Melatonin as a Hormone: New Physiological and Clinical Insights. In: Endocrine Reviews. 2018, Vol. 39, nr. 6, pp. 990-1028. PMID: 30215696 https://doi.org/10.1210/er.2018-00084
6. IDA E., JESPER B., GREGORY P., et al. Cardiovascular risk in young patients diagnosed with obstructive sleep apnea. In: American Heart Association. 2024, nr. 13(8), e033506. https://doi.org/10.1161/JAHA.123.033506
7. JYOTSNA F., AHMED A., KUMAR K., et al. Exploring the Complex Connection Between Diabetes and Cardiovascular Disease: Analyzing Approaches to Mitigate Cardiovascular Risk in Patients With Diabetes. In: Cureus. 2023, Vol.15; nr. 8, e43882. https://doi.org/10.7759/cureus.43882
8. KOO C., DRAGER L., SETHI R., et al. Sleep and Stent Study Investigators. Obstructive Sleep Apnea and Diabetes Independently Add to Cardiovascular Risk After Coronary Revascularization. In: Diabetes Care.2018, Vol. 41; nr. 2; pp. 12-14. PMID: 29208655 https://doi.org/10.2337/dc17-0759
9. MU Z., WANG Y., LI C. Association Between Tumor Necrosis Factor-α and Diabetic Peripheral Neuropathy in Patients with Type 2 Diabetes: a Meta-Analysis. In: Mol Neurobiol. 2017, Vol. 54; nr. 2; pp. 983-996. PMID: 26797519 https://doi.org/10.1007/s12035-016-9702-z
10. NEWHOUSE L., JOYNER M., CURRY T., et al. Three hours of intermittent hypoxia increases circulating glucose levels in healthy adults. In: Physiological Reports. 2017, Vol. 5; nr. 1. ISSN 2051-817X https://doi.org/10.14814/phy2.13106
11. O'CONNOR-REINA C., ALCALA L., IGNACIO J. Risk of diabetes in patients with sleep apnea: comparison of surgery versus CPAP in a long-term follow-up study. In: Journal of Otolaryngology - Head & Neck Surgery. 2023, nr. 52(1), 16 doi: 10.1186/s40463-022-00616-3. https://doi.org/10.1186/s40463-022-00616-3
12. PASCHOU S., BLETSA E., SALTIKI K., et al. Sleep Apnea and Cardiovascular Risk in Patients with Prediabetes and Type 2 Diabetes. In. Nutrients. 2022, Vol. 14, nr 23, pp 4978-4989. PMID: 36501019; PMCID: PMC9741445 https://doi.org/10.3390/nu14234989
13. QU H., GUO M., ZHANG Y., SHI DZ. Obstructive sleep apnea increases the risk of cardiac events after percutaneous coronary intervention: a meta-analysis of prospective cohort studies. In: Sleep Breath. 2018, Vol. 22, nr. 1, pp. 33-40. PMID: 28421375. https://doi.org/10.1007/s11325-017-1503-8
14. REUTRAKUL S., MOKHLESI B. Obstructive Sleep Apnea and Diabetes: A State of the Art Review. In: Chest. 2017, Vol. 152, nr. 5, pp. 1070-1086. PMID: 28527878; PMCID: PMC5812754 https://doi.org/10.1016/j.chest.2017.05.009
15. RINALDI V., COSTANTINO A., SABATINO L., CASALE M. Sleep Disordered Breathing and CPAP Treatment and Management. 2022, Vol. 4, nr/ 3, pp. 1002-1013. ISSN 2667-3681
16. ROMERO-CORRAL A., CAPLES S., LOPEZ-JIMENEZ F., SOMERS V. Interactions between obesity and obstructive sleep apnea: implications for treatment. In: Chest. 2010, Vol.137, nr. 3, pp. 711-7199. PMID: 20202954; PMCID: PMC3021364. https://doi.org/10.1378/chest.09-0360
17. SHI H., JIANG X. Correlation Between QTc Prolongation and Obstructive Sleep Apnea in Patients with Type 2 Diabetes Mellitus. In: Med Sci Monit. 2020, Vol. 26. PMID: 32853184; PMCID: PMC7478427 https://doi.org/10.12659/MSM.926954
18. Standards of Care in Diabetes-2024. January 2024, Volume 47, Supplement 1 ISSN: 0149-5992
19. STRAUSZ S., HAVULINNA A., TUOMI T., et al. Obstructive sleep apnea and the risk for coronary heart disease and type 2 diabetes: a longitudinal populationbased study in Finland. In: BMJ Open. 2018, Vol. 8, nr. https://doi.org/10.1136/bmjopen-2018-022752 10. PMID: 30327404; PMCID: PMC6194468
20. SU X., LI J., GAO Y., CHEN K., et al. Impact of obstructive sleep apnea complicated with type 2 diabetes on long-term cardiovascular risks and all-cause mortality in elderly patients. In: BMC Geriatr. 2021, Vol. 21, nr. 1. PMID: 34563134; PMCID: PMC8466658 https://doi.org/10.1186/s12877-021-02461-x
21. WANG H., LI X., TANG Z., GONG G. Cardiovascular Outcomes Post Percutaneous Coronary Intervention in Patients with Obstructive Sleep Apnea and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. In: Diabetes Ther. 2020, Vol. 11, nr. 8, pp. 1795-1806. PMID: 32591980; PMCID: PMC7376814 https://doi.org/10.1007/s13300-020-00870-6
22. XU J., LONG Y., GOZAL D., EPSTEIN P. Beta-cell death and proliferation after intermittent hypoxia: role of oxidative stress. In: Free Radical Biology and Medicine. 2009, Vol. 46, nr. 6, pp. 783-90. PMID: 19133326. https://doi.org/10.1016/j.freeradbiomed.2008.11.026
23. ZHANG S., KHALYFA A., WANG Y., et al. Sleep fragmentation promotes NADPH oxidase 2-mediated adipose tissue inflammation leading to insulin resistance in mice. In: Journal of Obesity (London). 2014, Vol. 38, nr. 4, pp. 619-24. PMID: 23897221; PMCID: PMC3907464. https://doi.org/10.1038/ijo.2013.139
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
