Driendl, Sarah and Stadler, Stefan and Arzt, Michael and Zeman, Florian and Heid, Iris M. and Baumert, Mathias (2024) Nocturnal hypoxemic burden and micro- and macrovascular disease in patients with type 2 diabetes. CARDIOVASCULAR DIABETOLOGY, 23 (1): 195. ISSN , 1475-2840
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Background Micro- and macrovascular diseases are common in patients with type 2 diabetes mellitus (T2D) and may be partly caused by nocturnal hypoxemia. The study aimed to characterize the composition of nocturnal hypoxemic burden and to assess its association with micro- and macrovascular disease in patients with T2D. Methods This cross-sectional analysis includes overnight oximetry from 1247 patients with T2D enrolled in the DIACORE (DIAbetes COhoRtE) study. Night-time spent below a peripheral oxygen saturation of 90% (T90) as well as T90 associated with non-specific drifts in oxygen saturation (T90(non - specific)), T90 associated with acute oxygen desaturation (T90(desaturation)) and desaturation depths were assessed. Binary logistic regression analyses adjusted for known risk factors (age, sex, smoking status, waist-hip ratio, duration of T2D, HbA1c, pulse pressure, low-density lipoprotein, use of statins, and use of renin-angiotensin-aldosterone system inhibitors) were used to assess the associations of such parameters of hypoxemic burden with chronic kidney disease (CKD) as a manifestation of microvascular disease and a composite of cardiovascular diseases (CVD) reflecting macrovascular disease. Results Patients with long T90 were significantly more often affected by CKD and CVD than patients with a lower hypoxemic burden (CKD 38% vs. 28%, p < 0.001; CVD 30% vs. 21%, p < 0.001). Continuous T90(desaturation) and desaturation depth were associated with CKD (adjusted OR 1.01 per unit, 95% CI [1.00; 1.01], p = 0.008 and OR 1.30, 95% CI [1.06; 1.61], p = 0.013, respectively) independently of other known risk factors for CKD. For CVD there was a thresholdeffect, and only severly and very severly increased T90(non-specific) was associated with CVD ([Q3;Q4] versus [Q1;Q2], adjusted OR 1.51, 95% CI [1.12; 2.05], p = 0.008) independently of other known risk factors for CVD. Conclusion While hypoxemic burden due to oxygen desaturations and the magnitude of desaturation depth were significantly associated with CKD, only severe hypoxemic burden due to non-specific drifts was associated with CVD. Specific types of hypoxemic burden may be related to micro- and macrovascular disease.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | OBSTRUCTIVE SLEEP-APNEA; CHRONIC KIDNEY-DISEASE; CARDIOVASCULAR-DISEASE; PROGNOSTIC VALUE; HEART-FAILURE; RISK; ASSOCIATION; MORTALITY; STROKE; METAANALYSIS; Hypoxia; Hypoxemic burden; Cardiovascular disease; Chronic kidney disease; Type 2 diabetes |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien Medicine > Institut für Epidemiologie und Präventivmedizin > Lehrstuhl für Genetische Epidemiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 15 Jan 2026 15:20 |
| Last Modified: | 15 Jan 2026 15:20 |
| URI: | https://pred.uni-regensburg.de/id/eprint/64001 |
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