文献类型：期刊文献

英文题名：Impact of obstructive sleep apnea complicated with type 2 diabetes on long-term cardiovascular risks and all-cause mortality in elderly patients

作者：Su, Xiaofeng[1];Li, Jian Hua[2,3];Gao, Yinghui[4];Chen, Kaibing[5];Gao, Yan[6];Guo, Jing Jing[7];Shi, Min[3,8];Zou, Xiao[2,3];Xu, Weihao[2,3];Zhao, Li Bo[2,3];Wang, Huanhuan[1];Wang, Yabin[2,3];Liu, Juan[2,3];Xu, Hu[2,3];Kong, Xiaoxuan[2,3];Lin, Junling[9];Qian, Xiaoshun[3,8];Han, Jiming[1];Liu, Lin[3,8]

第一作者：Su, Xiaofeng

通信作者：Han, JM[1];Qian, XS[2];Liu, L[2];Qian, XS[3];Liu, L[3]

机构：[1]Yanan Univ, Med Coll, Yanan, Shanxi, Peoples R China;[2]Chinese Peoples Liberat Army Gen Hosp, Med Ctr 2, Cardiol Dept, Beijing, Peoples R China;[3]Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, 28 Fuxing Rd, Beijing, Peoples R China;[4]Peking Univ Int Hosp, PKU UPenn Sleep Ctr, Beijing, Peoples R China;[5]Gansu Univ Chinese Med, Affiliated Hosp, Sleep Ctr, Lanzhou, Gansu, Peoples R China;[6]960th Hosp PLA, Dept Gen Practice, Jinan, Shandong, Peoples R China;[7]Peking Univ Peoples Hosp, Sleep Med Ctr, Dept Resp & Crit Care Med, Beijing, Peoples R China;[8]Chinese Peoples Liberat Army Gen Hosp, Med Ctr 2, Dept Resp & Crit Care Med, 28 Fuxing Rd, Beijing, Peoples R China;[9]Capital Med Univ, Beijing Chaoyang Hosp, Dept Resp & Crit Care Med, Beijing, Peoples R China

第一机构：Yanan Univ, Med Coll, Yanan, Shanxi, Peoples R China

通信机构：[1]corresponding author), Yanan Univ, Med Coll, Yanan, Shanxi, Peoples R China;[2]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, 28 Fuxing Rd, Beijing, Peoples R China;[3]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Med Ctr 2, Dept Resp & Crit Care Med, 28 Fuxing Rd, Beijing, Peoples R China.

年份：2021

卷号：21

期号：1

外文期刊名：BMC GERIATRICS

收录：;Scopus(收录号：2-s2.0-85115692185);WOS:【SSCI(收录号:WOS:000699021600003)，SCI-EXPANDED(收录号:WOS:000699021600003)】；

基金：This study was supported by Military Health Care Project (19BJZ34); Youth Program for Military Medicine of Chinese PLA General Hospital (QNC19054); Open Subject of National Clinical Research Center for Geriatric Diseases (NCRCG-PLAGH-2018008); Special Project of the Second Medical Center of PLA General Hospital (ZXD2008). The funders had not directly role in the design, data collection, analysis, interpretation or writing of the manuscript.

语种：英文

外文关键词：Obstructive sleep apnea; Type 2 diabetes; Elderly; Major adverse cardiovascular events; Mortality; Cardiovascular disease

摘要：Background The prognostic significance of obstructive sleep apnea (OSA) in elderly patients with type 2 diabetes is unclear. The aim of this study was to determine the risk of cardiovascular disease (CVD) and mortality in elderly patients with OSA complicated with type 2 diabetes compared to patients with OSA without type 2 diabetes. Methods From January 2015 to October 2017, 1113 eligible elderly patients with OSA, no history of cardiovascular, >= 60 years of age, and complete follow-up records were enrolled in this consecutive multicentre prospective cohort study. All patients had completed polysomnography (PSG) examinations. An apnoea-hypopnoea index of >= 5 events per hour recorded by polysomnography was defined as the diagnostic criterion for OSA. We collected baseline demographics, clinical characteristics, sleep parameters and follow-up outcomes. The primary aim of this study was to identify the risk of incident major adverse cardiovascular events (MACE). Secondary outcomes were all-cause mortality, components of MACE and a composite of all events. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate whether type 2 diabetes was associated with incident events. Results A total of 266 (23.9%) patients had OSA complicated with type 2 diabetes. MACE occurred in 97 patients during the median 42-month follow-up. Kaplan-Meier survival curves indicated a significant relationship between type 2 diabetes and MACE (log-rank P = 0.003). Multivariable Cox regression analysis showed that type 2 diabetes increased the risk of MACE (HR = 1.64, 95% CI:1.08-2.47, P = 0.019), hospitalisation for unstable angina (HR = 2.11, 95% CI:1.23-3.64, P = 0.007) and a composite of all events in elderly patients with OSA (HR = 1.70, 95% CI:1.17-2.49, P = 0.007). However, there were no significant differences in the incidence of cardiovascular death, all-cause mortality, MI and hospitalisation for heart failure between patients with and without diabetes (P > 0.05). The subgroup analysis demonstrated that females (AHR = 2.46, 95% CI:1.17-5.19, P = 0.018), >= 70 years (AHR = 1.95, 95% CI:1.08-3.52, P = 0.027), overweight and obese (AHR = 2.04, 95% CI:1.29-3.33, P = 0.002) with mild OSA (AHR = 2.42, 95% CI: 1.03-5.71, P = 0.044) were at a higher risk for MACE by diabetes. Conclusion OSA and type 2 diabetes are interrelated and synergistic with MACE, hospitalisation for unstable angina and a composite of all events development. Overweight and obese females, >= 70 years with mild OSA combined with type 2 diabetes presented a significantly high MACE risk.