Stadler, Stefan and Jalili, Shabnam and Schreib, Andreas and Jung, Bettina and Zeman, Florian and Boeger, Carsten A. and Heid, Iris M. and Arzt, Michael (2018) Association of sleep-disordered breathing with severe chronic vascular disease in patients with type 2 diabetes. SLEEP MEDICINE, 48. pp. 53-60. ISSN 1389-9457, 1878-5506
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Background: Severe chronic vascular disease (CVD) is a major cause of co-morbidity and mortality in patients with type 2 diabetes (DM2). Sleep-disordered breathing (SDB) has been linked to CVD in the general population due to enhanced sympathetic activation, oxidative stress, endothelial dysfunction, and hypertension; however data for DM2 patients is scarce. Therefore, the aim of the present analysis to assess whether SDB is associated with CVD in patients with DM2, independent of other known associated factors. Methods: We analyzed cross-sectional data of 679 patients with DM2 from the DIACORE-SDB sub-study for association of SDB with CVD. SDB was assessed with a validated 2-channel ambulatory monitoring device. CVD was ascertained as a previous diagnosis of peripheral artery disease (PAD), coronary artery disease (CAD), or stroke via medical records and general practitioners. Results: Of the analyzed 679 patients, 228 (34%) had SDB (respiratory event index [REI] >= 15/hour); and were significantly more often affected by CVD than patients without SDB (38% vs. 23%, p < 0.01; PAD 7% vs. 2%, p = 0.01; CAD 27% vs. 18%, p = 0.01; stroke 11% vs. 6%, p = 0.07). Regression analysis accounting for known modulators of CVD, such as age, body-mass index, systolic blood pressure, duration of DM2, HbA1c, smoking status, and low-density lipoprotein showed that the REI was independently associated with CVD (OR 1.099 per 5 REI points; 95%-CI = [1.024, 1.179]). Conclusions: In patients with DM2, SDB is significantly associated with CVD, independent of other known modulators of atherosclerosis. (C) 2018 Elsevier B.V. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | POSITIVE AIRWAY PRESSURE; CHRONIC HEART-FAILURE; CARDIOVASCULAR-DISEASE; RECORDING DEVICE; ARTERY-DISEASE; APNEA-HYPOPNEA; BLOOD-PRESSURE; STROKE; PREVALENCE; RISK; Sleep-disordered breathing; Chronic vascular disease; Coronary artery disease; Peripheral artery disease; Stroke; Type 2 diabetes |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II Medicine > Abteilung für Nephrologie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien Medicine > Institut für Epidemiologie und Präventivmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Mar 2020 12:06 |
| Last Modified: | 06 Mar 2020 12:06 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14192 |
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