Sleep and Breathing最新文献

{"title":"Screening for moderate to severe obstructive sleep apnea by using heart rate variability features based on random forest algorithm","authors":"Chenxu Zhang, Liangcai Yu, Lin Li, Ping Zeng, Xiaoqing Zhang","doi":"10.1007/s11325-024-03151-9","DOIUrl":"https://doi.org/10.1007/s11325-024-03151-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>More than 80% of patients with moderate to severe obstructive sleep apnea (OSA) are still not diagnosed timely. The prediction model based on random forest (RF) algorithm was established by using heart rate variability (HRV), clinical and demographic features so as to screen for the patients with high risk of moderate and severe obstructive sleep apnea.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The sleep monitoring data of 798 patients were randomly divided into training set (<i>n</i> = 558) and test set (<i>n</i> = 240) in 7:3 proportion. Grid search was applied to determine the best parameters of the RF model. 10-fold cross validation was utilized to evaluate the predictive performance of the RF model, which was then compared to the performance of the Logistic regression model.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Among the 798 patients, 638 were males and 160 were females, with the average age of 43.51 years old and the mean body mass index (BMI) of 25.92 kg/m². The sensitivity, specificity, accuracy, F1 score and the area under receiver operating characteristic curve for RF model and Logistic regression model were 94.68% vs. 73.94%; 73.08% vs. 86.54%; 90.00% vs. 76.67%; 0.94 vs. 0.83 and 0.83 vs. 0.80 respectively.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The RF prediction model can effectively distinguish patients with moderate to severe OSA, which is expected to carry out in a large-scale population in order to screening for high-risk patients, and helps to evaluate the effect of OSA treatment continuously.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-stage screening for obstructive sleep apnea in the primary practice setting","authors":"Andrej Pangerc, Marija Petek Šter, Leja Dolenc Grošelj","doi":"10.1007/s11325-024-03142-w","DOIUrl":"https://doi.org/10.1007/s11325-024-03142-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>To evaluate the effectiveness of a two-stage screening model for obstructive sleep apnea (OSA) in primary care that combines the STOP-BANG questionnaire (SBQ) with an automated home sleep apnea test (HSAT).</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This cross-sectional study was conducted from August 2018 to August 2022 in four Slovenian primary care practices. It included 153 randomly selected patients aged 18 to 70 years who visited the practice for any reason. Participants completed the SBQ and underwent HSAT with type III polygraphy on the same night. The HSAT recordings were scored automatically and by an experienced, accredited somnologist.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>There was a strong correlation between manual and automated HSAT scorings for the detection of OSA (Pearson’s r = 0.93). Cohen’s kappa was 0.80 for OSA (respiratory event index (REI) ≥ 5) and 0.77 for OSA severity categorization. The two-stage model demonstrated sensitivity of 64%, a specificity of 97.4%, a positive predictive value (PPV) of 96.0%, a negative predictive value (NPV) of 73.8% and an accuracy of 81.1% for any OSA (REI ≥ 5). For moderate to severe OSA (REI ≥ 15), the model showed 72.7% sensitivity, 96.7% specificity, 85.7% PPV, 92.8% NPV and 91.5% accuracy.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The two-stage model for OSA screening combining the SBQ and automated HSAT was shown to be effective in primary care, especially for moderate and severe OSA. This method provides a practical and efficient approach for the early detection of OSA.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of different masks on diaphragm motion in OSAS patients undergoing CPAP: results from an ultrasound-based proof of concept study.","authors":"Sonia Zotti, Simone Scarlata, Anna Annunziata, Lidia Atripaldi, Rosa Cauteruccio, Valentina Di Spirito, Claudio Pedone, Raffaele Antonelli-Incalzi, Giuseppe Fiorentino","doi":"10.1007/s11325-024-03155-5","DOIUrl":"https://doi.org/10.1007/s11325-024-03155-5","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) is characterized by recurrent upper airway narrowing or collapse during sleep. Continuous positive airway pressure (CPAP) remains the preferred treatment in selected patients and masks' choice plays an important role for subsequent respiratory events' reduction. It is known that oronasal masks are not as effective at opening the upper airway compared to nasal ones. Thus, the objective of this study was to investigate differences in US-assessed diaphragmatic excursion (DE) using oronasal vs. nasal CPAP masks.</p><p><strong>Methods: </strong>This observational study included 50 OSA patients presenting a moderate to severe apnea-hypopnea index and requiring CPAP treatment. All participants received US evaluations on diaphragm motion during their oronasal and nasal CPAP trial at equal positive end-expiratory pressure level.</p><p><strong>Results: </strong>The difference of DE switching mask during CPAP was assessed by using the non-parametric Wilcoxon signed-rank test. A statistically significant increase in US- assessed DE was found when shifting from oronasal to nasal mask (p-value < 0.01). Linear regression models revealed that increased neck circumference and more severe AHI were associated with decreased DE when shifting to an oronasal mask.</p><p><strong>Conclusion: </strong>This study evaluated the acute impact on US-assessed DE after changing CPAP route from oronasal to nasal mask. Our results suggest that the nasal type should be the more suitable option for most patients with OSA, especially those with higher nasal circumference. Diaphragmatic motion throughout US may become a practical tool to help in the choice of the fittest mask in patients undergoing CPAP.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting sleep quality in hospitalised patients.","authors":"Kavya Koshy, Matthew Gibney, Denise M O'Driscoll, Rowan P Ogeil, Alan C Young","doi":"10.1007/s11325-024-03144-8","DOIUrl":"https://doi.org/10.1007/s11325-024-03144-8","url":null,"abstract":"<p><strong>Introduction: </strong>Hospitalised patients are at increased risk of poor sleep quality which can negatively impact on recovery and quality of life. This study aimed to assess sleep quality in hospitalised patients and explore the factors associated with poor sleep.</p><p><strong>Methods: </strong>Prospective data were collected from 84 respiratory ward inpatients at time of discharge using a Likert scale questionnaire on contributing factors to sleep quality. Differences between groups reporting good and poor quality sleep were recorded.</p><p><strong>Results: </strong>Most participants (77%) described inpatient sleep quality to be worse or much worse compared to their home environment. Noise (39%), checking of vital signs (33%) and light (24%) were most frequently identified as factors disrupting sleep. Binary logistic regression analysis demonstrated that men (OR 2.8, CI 1.1-7.4, p = 0.037) and those in shared rooms (OR 3.9, CI 1.4-10.9, p = 0.009) were more likely to be affected by noise. Younger patients (OR 0.92, CI 0.88-0.96, p < 0.001) and those in shared rooms (OR 8.5 CI 1.9-37.9, p < 0.001) were more likely to be affected by light.</p><p><strong>Conclusion: </strong>In conclusion, a high proportion of hospitalised respiratory patients on a medical ward reported poorer sleep quality compared to home due to operational interruptions and noise. Age, gender and room type further modified the sleep disruption. Future research should focus on whether strategies to reduce interruptions and noise will improve sleep quality and clinical outcomes.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of supplemental oxygen and continuous positive airway pressure withdrawal on endocan levels.","authors":"Chris D Turnbull, John R Stradling, Nayia Petousi, Philippe Lassalle","doi":"10.1007/s11325-024-03120-2","DOIUrl":"https://doi.org/10.1007/s11325-024-03120-2","url":null,"abstract":"<p><strong>Purpose: </strong>Endocan is a biomarker of endothelial dysfunction, which is a precursor to cardiovascular disease. Obstructive sleep apnoea (OSA) is associated with elevated endocan levels but the effects of treatment on endocan levels in OSA are not fully established. We aimed to determine whether endocan levels could be detected by immunoassay and to determine the effect of supplemental oxygen during continuous positive airway pressure (CPAP) withdrawal on circulating endocan levels.</p><p><strong>Methods: </strong>We conducted an exploratory analysis from a randomised controlled crossover study which included participants with OSA. Participants stopped their CPAP therapy and were randomised to receive either supplemental oxygen or sham for 14 nights before crossing over. Supplemental oxygen blocked the rise in blood pressure seen in the sham group. We analysed plasma endocan levels by immunoassay at baseline and after 14 nights of intervention in both groups.</p><p><strong>Results: </strong>Twenty-five participants were included, with a total of 100 samples. Endocan levels were detectable at all time points in 22 participants (88%), and in 93 (93%) samples. Supplemental oxygen had no effect on endocan levels compared to sham (+ 0.52 ng/ml, 95%CI -0.21 to + 1.25, p = 0.16), and there was no significant difference in endocan levels from baseline to follow-up in either the sham (-0.30 ng/ml, 95%CI -0.89 to + 0.30, p = 0.31) or supplemental oxygen (+ 0.22 ng/ml, 95%CI 0.00 to + 0.44, p = 0.05) arm.</p><p><strong>Conclusions: </strong>We have shown that endocan levels are detectable before and after CPAP withdrawal. However, we found no effect of supplemental oxygen following CPAP withdrawal on circulating endocan levels.</p><p><strong>Trial registration and date: </strong>ISRCTN 17,987,510 19/02/2015.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mandibular device treatment in obstructive sleep apnea -A structured therapy adjustment considering night-to-night variability night-to-night variability in mandibular devices.","authors":"Greta Sophie Papenfuß, Inke R König, Christina Hagen, Alex Frydrychowicz, Fenja Zell, Alina Janna Ibbeken, Thorsten M Buzug, Ulrike Kirstein, Lina Kreft, Daniel Grünberg, Samer Hakim, Armin Steffen","doi":"10.1007/s11325-024-03134-w","DOIUrl":"https://doi.org/10.1007/s11325-024-03134-w","url":null,"abstract":"<p><strong>Background: </strong>Mandibular advancement devices (MAD) are a well-established treatment option for obstructive sleep apnea (OSA). MAD are considered preferably for patients with mild to moderate OSA presenting with a elevated night-to-night variability (NNV). This study aimed to determine the treatment effect of MAD on NNV considering different protrusion distances and patient related outcome (PRO).</p><p><strong>Methods: </strong>We conducted a prospective cohort analysis of patients before MAD with 60% and 80% of the maximum protrusion. OSA severity was assessed using a home-sleep test for two consecutive nights. PRO contained the Epworth Sleepiness Scale (ESS) and sleep related quality of life (FOSQ).</p><p><strong>Results: </strong>Twenty patients with a median overweight body-mass-index of 27.1 (interquartile range (IQR) 16.3 kg/m²), with a mainly mild to moderate OSA with an apnea -hypopnea index (AHI) of 18.3 / h (IQR 17.7) and elevated ESS of 12.5 (IQR 8.0) were included. As opposed to 80%, 60% protrusion significantly but not 80% relevantly reduced AHI (60%%: 11.2 (IQR 5.5)/h, p = 0.01; 80%: 12.9 (IQR18,0)/h, p = 0.32) and improved the ESS (60%: 8.0 (IQR 10,0); 80%: 10 (IQR 9.0)), with therapy settings. No correlation could be detected between NNV and ESS, and FOSQ changes. Higher baseline NNV was associated with severe OSA (p = 0.02) but not with gender, overweight, or status post-tonsillectomy.</p><p><strong>Conclusions: </strong>OSA improvement is associated with lower NNV; both OSA and NNV are connected to the degree of protrusion. Therefore, higher NNV does not justify the exclusion of candidates for MAD treatment. PRO changes are not visibly affected by NNV but by general OSA changes. These findings may help to define and optimize future study designs for the primary outcome decision between objective OSA parameters and PRO.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of obstructive sleep apnoea on postoperative outcomes of patients undergoing coronary artery bypass grafting: a systematic review and meta-analysis.","authors":"Yajing Ni, Yan Zhou","doi":"10.1007/s11325-024-03154-6","DOIUrl":"https://doi.org/10.1007/s11325-024-03154-6","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between obstructive sleep apnoea (OSA) and postoperative complications in patients after coronary artery bypass graft (CABG).</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science and Scopus databases were explored to identify relevant observational studies that reported incidences of OSA in CABG patients, and assessed OSA using standard objective methods such as polysomnography (PSG). The primary outcomes of interest were risk of major adverse cardiac and cerebrovascular events (MACCE) and all-cause mortality. Pooled effect sizes were reported as odds ratio (OR) with 95% confidence intervals.</p><p><strong>Results: </strong>Twelve studies were included. All studies, except one, had a prospective cohort design. CABG patients with OSA had increased risk of MACCE (OR 1.71, 95% CI: 1.16, 2.53), myocardial infarction (MI) (OR 2.21, 95% CI: 1.19, 4.13), pulmonary complications (OR 1.86, 95% CI: 1.03, 3.38), renal complications (OR 8.14, 95% CI: 2.07, 32.1), heart failure (OR 1.86, 95% CI: 1.19, 2.89) and need for revascularization (OR 2.80, 95% CI: 1.01, 7.75). However, risk of all-cause mortality (OR 1.63, 95% CI: 0.75, 3.52) was comparable in all patients.</p><p><strong>Conclusion: </strong>This study showed that OSA significantly correlates with the increased risk of major adverse events. Our results indicate that recognizing and managing OSA in CABG patients is crucial for mitigating associated risks.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-specific association between snoring and total sleep duration with type 2 diabetes mellitus in rural adults.","authors":"Xili Jiang, Ruifang Zhu, Ruiying Li, Xiaokang Dong, Yinghao Yuchi, Gaohua Chang, Yujie Jiang, Xiaoying Ren, Chongjian Wang, Xiaotian Liu","doi":"10.1007/s11325-024-03133-x","DOIUrl":"https://doi.org/10.1007/s11325-024-03133-x","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the separate and joint association between snoring and total sleep duration with the risk of type 2 diabetes mellitus (T2DM) in both genders within Chinese rural community.</p><p><strong>Methods: </strong>The Henan Rural Cohort Study included a total of 28093 participants. Data on snoring and total sleep duration were obtained through the Pittsburgh Sleep Quality Index (PSQI). Binary logistic regression was employed to assess the correlation between snoring and total sleep duration with T2DM.</p><p><strong>Results: </strong>The prevalences of T2DM were 8.53% in males and 9.27% in females. Males exhibited a higher prevalence of snoring (34.90%) compared to females (22.42%), and the median of total sleep duration was also longer in males (8.83 h) than in females (8.67 h), respectively (P < 0.001). Females who snored had an adjusted odds ratio (OR) and 95% confidence interval (CI) for T2DM of 1.19 (1.06, 1.35) when contrasted with non-snorers. Compared with optimal total sleep duration (6-8 h), longer total sleep duration (≥ 8 h) increased the prevalence of T2DM by 17% (95%CI: 3%, 32%) in females. Additionally, the participants with shorter total sleep duration (< 6 h) and snoring have the highest risk of T2DM, with an increase of 91% (95%CI: 20%, 204%) than those with optimal total sleep duration and non-snorers in females. These significant associations were not found in males.</p><p><strong>Conclusions: </strong>Snoring and longer total sleep duration independently elevated the prevalence of T2DM. Meantime, a synergistic relationship was observed between snoring and total sleep duration with a higher prevalence of T2DM. These associations exhibited gender-specific differences.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep disturbances based on patient reported outcomes in patients with breast cancer.","authors":"Saadia A Faiz, Ashley S Knox, Bryan Fellman, Bibi Aneesah Jaumally, G Nancy Pacheco, Aneesa Das, Reeba Mathew, Rashmi Murthy, Jennifer K Litton, Diwakar D Balachandran, Lara Bashoura","doi":"10.1007/s11325-024-03150-w","DOIUrl":"https://doi.org/10.1007/s11325-024-03150-w","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep disturbances are common in patients with breast cancer, but comprehensive evaluations with patient-reported outcomes (PRO) and sleep evaluation with polysomnography (PSG) are lacking. This study describes sleep disruption using PROs and PSG to identify underlying sleep disorders.</p><p><strong>Methods: </strong>A retrospective review of patients with breast cancer undergoing formal sleep evaluation from 4/1/2009 to 7/31/2014 was performed. Clinical characteristics, PROs using Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), and PSG data were reviewed.</p><p><strong>Results: </strong>404 patients were identified with 43% early, 30% locally advanced and 17% metastatic disease. PSQI revealed poor sleep in 75%, and ESS demonstrated daytime sleepiness in 55%. Sleep aid use was reported by 39%, and pain medication use in 22%. Most patients (50.2%) had multiple sleep disorders. Insomnia (54.5%) was the most frequent sleep disorder, followed closely by obstructive sleep apnea (OSA) (53.7%). PSG was performed in 74%. Multivariate analysis linked poor sleep to use of sleep aids [OR 7.7, 95% CI 3.9 to 15.2], anxiety disorder [OR 4.8, 95% CI 1.7 to 14.0], and metastatic disease [OR 2.8, 95% CI 1.1 to 6.6]. Daytime sleepiness correlated with known diagnosis of OSA [OR 1.9, 95% CI 1.0 to 3.3] and sleep aid use [OR 0.6, 95% CI 0.4 to 0.9].</p><p><strong>Conclusions: </strong>Poor sleep was associated with sleep aid use, anxiety disorder and metastatic disease. Insomnia was the most common sleep disorder, followed by OSA (mostly mild). Education about sleep health and proactive screening for sleep symptoms would be beneficial in patients with breast cancer.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mediating effect of TyG and its derived indices in the association between OSAHS and atherosclerosis in patients with T2DM.","authors":"Ling Ding, Xiaohong Jiang","doi":"10.1007/s11325-024-03081-6","DOIUrl":"https://doi.org/10.1007/s11325-024-03081-6","url":null,"abstract":"<p><strong>Objective: </strong>Triglyceride-glucose index (TyG) and its derived indices which better reflect metabolic disturbances on atherosclerosis has not been reliably compared in patients with type 2 diabetes mellitus (T2DM). Besides, obstructive sleep apnea hypopnea syndrome (OSAHS), a driver of atherosclerosis (AS), can exacerbate metabolic disturbances strongly. The aim of this study is to explore the mediating effect of glycolipid metabolism on the association between OSAHS and arterial stiffness in T2DM patients.</p><p><strong>Methods: </strong>154 T2DM patients were involved in this study and were split into two groups: T2DM and T2DM + AS. Logistic regression analysis determined the accurate effects of different factors on the AS of T2DM patients. The capacity of TyG and the indices it derives to predict AS was assessed using the receiver operating characteristic (ROC) curve. Mediation analysis was employed to investigate the mediating effect of TyG and its derived indices on the association between OSAHS and arterial stiffness in T2DM patients.</p><p><strong>Results: </strong>OSAHS, TyG, and its derived indices were independent risk factors for AS in T2DM patients. Stratified by age, the hazardous effects of TyG and its derived indices remained significant in T2DM patients aged ≥ 50 years, but not in those aged < 50 years. In T2DM patients aged ≥ 50 years, the novel indices have a high predictive value for AS, with TyG-BMI exhibiting the largest AUC(AUC:0.788;95% CI:0.647 ∼ 0.928; P < 0.001). The mediation analysis results indicated that in T2DM patients aged ≥ 50 years, TyG, TyG-BMI, TyG-WC, and TyG-WHtR acted as potential mediators in the association between OSAHS and AS, with mediation effects of 33.42%, 48.2%, 37.7%, and 40.21%, respectively. However, there was no significant mediating effect observed in the younger patients.</p><p><strong>Conclusion: </strong>TyG and its derived indices are strongly correlated with AS in T2DM patients, of which TyG-BMI has the best predictive performance. Besides, OSAHS partially exerts its atherogenic effect through glucolipid metabolism disorder in the T2DM population aged ≥ 50 years, while it mainly exerts a direct atherogenic effect in patients aged < 50 years.</p>","PeriodicalId":21862,"journal":{"name":"Sleep and Breathing","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}