Background: This meta-analysis was performed to quantitatively evaluate the dose-response association between obstructive sleep apnea (OSA) and risk of type 2 diabetes mellitus (T2DM).
Methods: PubMed, Embase, and Web of Science were searched up to 12 December 2018 for articles that assessed the OSA-T2DM association. Random effects models were used to analyze the quantitative association between OSA and risk of T2DM. Restricted cubic splines were used to model the dose-response association between apnea-hypopnea index (AHI), used to assess the severity of OSA according to events/h, and risk of T2DM.
Results: We included 16 cohort studies in our meta-analysis. During a median follow-up of 10.5 years (range: 3.0-22.0), 19 355 T2DM cases were reported among 338 912 study participants. The pooled relative risk of T2DM was 1.40 (95% CI, 1.32-1.48) for OSA in the binary meta-analysis and 1.08 (1.01-1.14) for each 5-event/h increase in AHI value. We found a positive linear association between OSA and T2DM risk.
Conclusions: Our dose-response meta-analysis revealed a linear association between OSA and T2DM.
背景: 该研究对阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea, OSA)和2型糖尿病发病风险的关系进行定量评价, 并探索其潜在的剂量-反应关系。 方法: 检索PubMed、Embase和 Web of Science数据库中2018年12月12日前发表的关于OSA和2型糖尿病的相关性研究。采用随机效应模型定量分析OSA和2型糖尿病发病风险的关系。通过限制性立方样条模型评估呼吸暂停低通气指数(基于次数/小时评价OSA严重程度的指标)和2型糖尿病发病风险的剂量-反应关系。 结果: 本研究共纳入16个队列研究, 包括研究对象 338,912人, 随访时间为中位数10.5年(范围为3.0-22.0年), 随访期间19,355名研究对象确诊2型糖尿病。二元meta分析显示OSA使2型糖尿病的发病相对风险度为1.40 ( 95%CI:1.32-1.48), 呼吸暂停低通气指数每增加5次/小时, 2型糖尿病的发病相对风险度为1.08(95%CI:1.01-1.14)。OSA与2型糖尿病的发病风险成线性正相关。 结论: OSA的严重程度和2型糖尿病的发病风险有关, 且存在线性剂量-反应关系。.
Keywords: 2型糖尿病; cohort studies; dose-response; meta-analysis; obstructive sleep apnea; type 2 diabetes mellitus; 剂量-反应; 荟萃分析; 队列研究; 阻塞性呼吸睡眠暂停综合征.
© 2019 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.