Association of obstructive sleep apnea symptoms with all-cause mortality and cause-specific mortality in adults with or without diabetes: A cohort study based on the NHANES

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2024-04-10 DOI:10.1111/1753-0407.13538

Qian Zhang, Qi Zhang, Xiaomin Li, Gang Du, Xiaojin Feng, Runtao Ding, Yuhua Chi, Yongping Liu

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引用次数: 0

Abstract

Background

The association between obstructive sleep apnea syndrome (OSAS) and mortality has not been extensively researched among individuals with varying diabetic status. This study aimed to compare the relationship of OSAS with all-cause and cause-specific mortality in US individuals with or without diabetes based on data from the National Health and Nutrition Examination Survey (NHANES).

Methods

The study included participants from the NHANES 2005–2008 and 2015–2018 cycles with follow-up information. OSAS data (OSAS.MAP10) was estimated from the questionnaire. Hazard ratios (HRs) and the 95% confidence interval (CI) of OSAS for mortality were calculated by Cox regression analysis in populations with different diabetes status. The relationships between OSAS and mortality risk were examined using survival curves and restricted cubic spline curves.

Results

A total of 13 761 participants with 7.68 ± 0.042 follow-up years were included. In the nondiabetic group, OSAS.MAP10 was positively associated with all-cause, cardiovascular, and cancer mortality. In individuals with prediabetes, OSAS.MAP10 was positively related to all-cause mortality (HR 1.11 [95% CI: 1.03–1.20]) and cardiovascular mortality (HR 1.17 [95% CI: 1.03–1.33]). The relationship between OSAS.MAP10 and the risk of all-cause mortality and cancer mortality exhibited L-shaped curves in diabetes patients (both with nonlinear p values <.01). Further threshold effect analysis revealed that OSAS was positively related to death risk when OSAS.MAP10 exceeded the threshold scores.

Conclusion

The relationship between OSAS and mortality differed among participants with or without diabetes. Individualized clinical treatment plans should be developed in clinical practice to reduce the risk of death for patients with different metabolic conditions.

Abstract Image

查看原文本刊更多论文

阻塞性睡眠呼吸暂停症状与糖尿病或非糖尿病成人全因死亡率和特定原因死亡率的关系：基于 NHANES 的队列研究

背景尚未对不同糖尿病患者的阻塞性睡眠呼吸暂停综合症（OSAS）与死亡率之间的关系进行广泛研究。本研究旨在根据美国国家健康与营养调查（NHANES）的数据，比较 OSAS 与美国糖尿病患者或非糖尿病患者的全因死亡率和特定原因死亡率之间的关系。研究方法该研究纳入了 NHANES 2005-2008 年和 2015-2018 年周期中具有随访信息的参与者。根据问卷估算出 OSAS 数据（OSAS.MAP10）。通过考克斯回归分析，计算了不同糖尿病状态人群中OSAS与死亡率的危险比（HRs）和95%置信区间（CI）。利用生存曲线和限制性三次样条曲线研究了 OSAS 与死亡风险之间的关系。结果共纳入 13 761 名参与者，随访年数为 7.68 ± 0.042 年。在非糖尿病组中，OSAS.MAP10 与全因死亡率、心血管死亡率和癌症死亡率呈正相关。在糖尿病前期患者中，OSAS.MAP10 与全因死亡率（HR 1.11 [95% CI：1.03-1.20]）和心血管死亡率（HR 1.17 [95% CI：1.03-1.33]）呈正相关。在糖尿病患者中，OSAS.MAP10 与全因死亡和癌症死亡风险之间的关系呈现出 L 型曲线（两者的 p 值均为非线性 p<.01）。进一步的阈值效应分析显示，当 OSAS.MAP10 超过阈值分数时，OSAS 与死亡风险呈正相关。结论 OSAS与死亡率之间的关系在有糖尿病或无糖尿病的参与者中存在差异。临床实践中应制定个体化的临床治疗方案，以降低不同代谢状况患者的死亡风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.