[Show abstract][Hide abstract] ABSTRACT: To address the influence of gender and obstructive sleep apnea (OSA) on development of diabetes mellitus (DM) in a sleep clinic cohort.
A longitudinal observational study.
A consecutive middle-aged (30-69 years) sleep clinic cohort from 1991 (n=318; 254 men, 64 women) with eligible baseline characteristics, clinical charts, and information from the Swedish Hospital Discharge Registry were identified. Ten individuals with DM at baseline and 47 patients who died during the follow-up period were excluded.
The remaining 261 subjects were asked to complete a postal questionnaire regarding concomitant diseases including DM, diagnosed by a physician.
In total, 168 patients (64.4%) replied. The incidence of DM was 24.9% in patients with OSA (overnight oxygen desaturations > or =30 in 1991) compared with 10.8% in subjects without OSA (p = 0.020). New-onset DM in men was 19.1% in OSA vs. 11.1% in non-OSA (n.s.), while the corresponding values in women were 50.0% in OSA and 9.5% in non-OSA (p = 0.022). In a multivariate analysis, DM was predicted by OSA in women with an odds ratio (OR) of 11.8, but not by age, body mass index (BMI) at baseline, or weight change at followup. In men, only BMI (OR 1.16) predicted DM.
The contribution of OSA to DM development seems to be gender-dependent and higher in women than in men.
Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 06/2010; 6(3):244-50. · 3.05 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Obstructive sleep apnea (OSA) is a common condition in patients with cardiovascular diseases (CVD). The first line treatment of OSA is continuous positive airway pressure (CPAP), which reduces daytime sleepiness and improves quality of life in sleep-clinic based populations. However, in the cardiac populations, the majority of OSA subjects do not report daytime sleepiness. To date, there is not enough evidence to draw the conclusion that all CVD patients should be investigated for OSA and subsequently be treated with CPAP. The current article focuses on the available research evidence addressing the impact of CPAP on the cardiovascular consequences of OSA in both clinic- and population-based cohorts.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 06/2010; 10(3):274-80. DOI:10.5152/akd.2010.070 · 0.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Obstructive sleep apnea (OSA) is a common disorder with serious cardiovascular consequences. The pathogenesis in this context is likely to be multifactorial process including large negative swings in intrathoracic pressure, intermittent hypoxemia and hypercapnia, increased sympathetic nervous system activity, vascular endothelial dysfunction, oxidative stress, systemic inflammation, excessive platelet activation as well as metabolic dysregulation. Although there is scientific support for a considerable impact of OSA on vascular structure and function, it is likely that development of cardiovascular diseases is determined by multiple genotypic and phenotypic factors. The current article focuses on the available research evidence addressing the cardiovascular mechanisms in this context.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 04/2010; 10(2):168-75. DOI:10.5152/akd.2010.044 · 0.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Obstructive sleep apnea (OSA) is common in general population. There is an accumulating research evidence for an independent relationship between OSA and cardiovascular morbidity and mortality. This relationship is stronger in clinical cohorts compared with the general population, which suggests that concomitant OSA in subjects with traditionally recognized risk factors such as obesity, hypertension, smoking, and hyperlipidemia may provide an additive risk factor for the cardiovascular consequences. In the current article, the clinic-and population-based epidemiologic data will be reviewed in this context.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 02/2010; 10(1):75-80. DOI:10.5152/akd.2010.017 · 0.93 Impact Factor