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Risk of mortality among patients with moderate to severe obstructive sleep apnea and diabetes mellitus: results from the SantOSA cohort

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Introduction

Patients with obstructive sleep apnea (OSA) and comorbid diabetes mellitus (DM) are reported to have an increased risk of cardiovascular (CV) outcomes; however, data on CV mortality are scant.

Aim

This study aimed to evaluate if patients with comorbid OSA and DM have an increased risk of CV mortality that is higher than the two diseases in isolation.

Methods

In this prospective cohort study, we included patients referred for a sleep study with and without DM at baseline. We developed four study groups as follows: group 1 (reference group), OSA (−) DM (−); group 2, OSA (−) DM (+); group 3, OSA (+) DM (−); group 4, OSA (+) DM (+). Intergroup differences were evaluated using the t test and χ2 test, and multivariate analysis was performed using logistic regression. The incidence rates of CV mortality were calculated using the Kaplan–Meier (log-rank) model, and adjusted HRs were calculated using the Cox regression model.

Results

A total of 1447 patients were included in the analysis—group 1: 441 participants; group 2: 141 participants; group 3: 736 participants; group 4: 151 participants. The mean follow-up was 5 years. The association between OSA + DM showed an independent risk of incident CV mortality (HR 2.37, CI 1.16–4.82, p = 0.02) and an increased prevalence of coronary heart disease (OR 3.44, CI 1.73–5.59, p < 0.01). In addition, T90% was also associated with CV mortality.

Conclusion

The coexistence of OSA + DM was associated with an independent risk of CV mortality. In addition, T90% was also associated with CV mortality.

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Author information

Authors and Affiliations

  1. Facultad de Medicina, Universidad de Concepcion, Barrio Universitario S/N, Concepcion, Chile

    Gonzalo Labarca, Alexia Schmidt & Francisca Rivera

  2. Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepcion, Concepcion, Chile

    Gonzalo Labarca

  3. Centro de Enfermedades Respiratorias y grupo de estudio trastornos respiratorios del sueño (GETRS) Clínica Las Condes, Santiago, Chile

    Jorge Dreyse, Constanza Salas, Francisca Letelier & Jorge Jorquera

Authors
  1. Gonzalo Labarca
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  2. Jorge Dreyse
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  3. Constanza Salas
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  4. Alexia Schmidt
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  5. Francisca Rivera
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  6. Francisca Letelier
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  7. Jorge Jorquera
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Contributions

Study design and ISRCTN register: G.L., J.J. Data analysis: J.D., F.L., C.S., A.S., F.R. Interpretation of the results: G.L., J.D., A.S., F.R., J.J. Manuscript preparation: G.L., J.J., A.S., F.R., J.D. Manuscript revision, editing, and approval: G.L., J.D., F.L., C.S., J.J. All authors approved the final manuscript.

Corresponding author

Correspondence to Gonzalo Labarca.

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Conflict of interest

The authors declare that they have no competing interests.

Study register

ISRCTN62293645

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee from Clinica Las Condes, IRB: 00008758, Santiago, Chile, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the prospective cohort included in the study.

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Labarca, G., Dreyse, J., Salas, C. et al. Risk of mortality among patients with moderate to severe obstructive sleep apnea and diabetes mellitus: results from the SantOSA cohort. Sleep Breath 25, 1467–1475 (2021). https://doi.org/10.1007/s11325-020-02283-y

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  • DOI: https://doi.org/10.1007/s11325-020-02283-y

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