Prevalence of type 2 diabetes in patients with obstructive sleep apnea in a multi-ethnic sample.
STUDY OBJECTIVES: Relationship of obstructive sleep apnea (OSA) with insulin resistance and type 2 diabetes in Caucasians has been studied, but this association has not been investigated in Hispanic and African-Americans. The objective of this study is to determine the prevalence of type 2 diabetes in patients evaluated for OSA in a predominantly African American and Hispanic sample. The secondary objective is to evaluate the relationship of REM related OSA and type 2 diabetes. METHODS: 1008 consecutive patients who had a comprehensive polysomnography were evaluated. OSA was defined as an obstructive apnea-hypopnea index (AHI) of > or = 5 per hour. REM AHI of > or = 10 was considered to indicate REM related OSA. RESULTS: The prevalence of type 2 diabetes was 30.1% in the group with OSA compared to 18.6% in those without OSA. The subjects with OSA had significantly increased odds of type 2 diabetes compared with those without OSA (odds ratio = 1.8, 95% confidence interval: 1.3-2.6) but this association became non-significant when controlled for confounding variables and covariates (odds ratio = 1.3, 95% confidence interval: 0.9-2.0). Middle-aged participants with OSA had 2.8 times higher odds for type 2 diabetes, when compared to younger or middle aged without OSA, controlling for covariates. Finally, the odds of type 2 diabetes were 2.0 times higher in patients with REM AHI of > or = 10/h independent of confounding variables. CONCLUSIONS: OSA is not independently associated with type 2 diabetes in a predominantly African American and Hispanic sample. However, the relationship of REM related OSAwith type 2 diabetes may be statistically significant.
Mahmood, K; Akhter, N; Eldeirawi, K; Onal, E; Christman, JW; Carley, DW; Herdegen, JJ
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