a9c5cfea2d3234c5e54015d63519aa04 pmc_8910907.pdf 4c46e037ba6ef3a3e24ccacda5496a680e409b68 pmc_8910907.pdf 92a9a41594358ba45bb263da9de7c8a2bd6ad0017bed63ddbee8cf040a76a262 pmc_8910907.pdf Title: Prediabetes Is Associated with Increased Prevalence of Sleep-Disordered Breathing Subject: Type 2 diabetes leads to severe nocturnal hypoxemia, with an increase in apnea events and daytime sleepiness. Hence, we assessed sleep breathing parameters in the prediabetes stage. A cross-sectional study conducted on 966 middle-aged subjects without known pulmonary disease (311 patients with prediabetes and 655 controls with normal glucose metabolism) was conducted. Prediabetes was defined by glycated hemoglobin (HbA1c), and a nonattended overnight home sleep study was performed. Participants with prediabetes (n = 311) displayed a higher apnea–hypopnea index (AHI: 12.7 (6.1;24.3) vs. 9.5 (4.2;19.6) events/h, p < 0.001) and hypopnea index (HI: 8.4 (4.0;14.9) vs. 6.0 (2.7;12.6) events/h, p < 0.001) than controls, without differences in the apnea index. Altogether, the prevalence of obstructive sleep apnea was higher in subjects with prediabetes than in controls (78.1 vs. 69.9%, p = 0.007). Additionally, subjects with prediabetes presented impaired measurements of the median and minimum nocturnal oxygen saturation, the percentage of time spent with oxygen saturations below 90%, and the 4% oxygen desaturation index in comparison with individuals without prediabetes (p < 0.001 for all). After adjusting for age, sex, and the presence of obesity, HbA1c correlated with the HI in the entire population (r = 0.141, p < 0.001), and the presence of prediabetes was independently associated with the AHI (B = 2.20 (0.10 to 4.31), p = 0.040) as well as the HI (B = 1.87 (0.61 to 3.14), p = 0.004) in the multiple linear regression model. We conclude that prediabetes is an independent risk factor for an increased AHI after adjusting for age, sex, and obesity. The enhanced AHI is mainly associated with increments in the hypopnea events. Keywords: apnea; glycated hemoglobin; hypopnea; prediabetes; obstructive sleep apnea Author: Enric Sánchez, Esther Sapiña-Beltrán, Ricard Gavaldà, Ferran Barbé, Gerard Torres, Ariadna Sauret, Mireia Dalmases, Carolina López-Cano, Liliana Gutiérrez-Carrasquilla, Marcelino Bermúdez-López, Elvira Fernández, Francisco Purroy, Eva Castro-Boqué, Cristina Farràs-Sallés, Reinald Pamplona, Dídac Mauricio, Cristina Hernández, Rafael Simó, Albert Lecube and on behalf of the ILERVAS Project Collaborators Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Mar 4 10:17:45 2022 CET ModDate: Fri Mar 4 10:20:57 2022 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 457276 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- UQZHSH+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 OWJUNQ+VnURWPalladioL Type 1 Custom yes yes no 15 0 JVKMBM+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 SMQCNQ+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 FYVVKY+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 36 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 40 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 44 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 56 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 59 0 CNXSVA+CMSY10 Type 1 Builtin yes yes no 84 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 94 0 JJLKLK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 101 0 JJLKLL+PalatinoLinotype CID TrueType Identity-H yes yes yes 104 0 JJLKLM+PalatinoLinotype TrueType WinAnsi yes yes no 110 0 JJLKMO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 113 0 JJLNEB+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 116 0 CRUZTT+VnURWPalladioL-Italic Type 1 Custom yes yes no 135 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-06-13 02:34:07 CEST RepresentationInformation: pmc_8910907.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-03-28 07:25:53 CEST Size: 457276 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 283 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Ethics Approval Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Design of the Study and Report of the Study Individuals Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Diagnosis of Prediabetes Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Nighttime Respiratory Function Assessment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Excessive Daytime Sleepiness Assessment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Covariates Assessment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Info: Title: Prediabetes Is Associated with Increased Prevalence of Sleep-Disordered Breathing Author: Enric Sánchez, Esther Sapiña-Beltrán, Ricard Gavaldà, Ferran Barbé, Gerard Torres, Ariadna Sauret, Mireia Dalmases, Carolina López-Cano, Liliana Gutiérrez-Carrasquilla, Marcelino Bermúdez-López, Elvira Fernández, Francisco Purroy, Eva Castro-Boqué, Cristina Farràs-Sallés, Reinald Pamplona, Dídac Mauricio, Cristina Hernández, Rafael Simó, Albert Lecube and on behalf of the ILERVAS Project Collaborators Subject: Type 2 diabetes leads to severe nocturnal hypoxemia, with an increase in apnea events and daytime sleepiness. Hence, we assessed sleep breathing parameters in the prediabetes stage. A cross-sectional study conducted on 966 middle-aged subjects without known pulmonary disease (311 patients with prediabetes and 655 controls with normal glucose metabolism) was conducted. Prediabetes was defined by glycated hemoglobin (HbA1c), and a nonattended overnight home sleep study was performed. Participants with prediabetes (n = 311) displayed a higher apnea hypopnea index (AHI: 12.7 (6.1;24.3) vs. 9.5 (4.2;19.6) events/h, p < 0.001) and hypopnea index (HI: 8.4 (4.0;14.9) vs. 6.0 (2.7;12.6) events/h, p < 0.001) than controls, without differences in the apnea index. Altogether, the prevalence of obstructive sleep apnea was higher in subjects with prediabetes than in controls (78.1 vs. 69.9%, p = 0.007). Additionally, subjects with prediabetes presented impaired measurements of the median and minimum nocturnal oxygen saturation, the percentage of time spent with oxygen saturations below 90%, and the 4% oxygen desaturation index in comparison with individuals without prediabetes (p < 0.001 for all). After adjusting for age, sex, and the presence of obesity, HbA1c correlated with the HI in the entire population (r = 0.141, p < 0.001), and the presence of prediabetes was independently associated with the AHI (B = 2.20 (0.10 to 4.31), p = 0.040) as well as the HI (B = 1.87 (0.61 to 3.14), p = 0.004) in the multiple linear regression model. We conclude that prediabetes is an independent risk factor for an increased AHI after adjusting for age, sex, and obesity. The enhanced AHI is mainly associated with increments in the hypopnea events. 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