Sympathetic Hyperactivity and Sleep Disorders in Individuals With Type 2 Diabetes
López-Cano, Carolina (Institut de Recerca Biomèdica)
Gutiérrez-Carrasquilla, Liliana (Institut de Recerca Biomèdica)
Sánchez, Enric (Institut de Recerca Biomèdica)
González Gutiérrez, Jessica (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Yeramian, Andrei (Institut de Recerca Biomèdica)
Martí, Raquel (Institut de Recerca Biomèdica)
Hernández, Marta (Institut de Recerca Biomèdica)
Cao, Gonzalo (Hospital Arnau de Vilanova (Lleida, Catalunya))
Ribelles, Mercè (Hospital Arnau de Vilanova (Lleida, Catalunya))
Gómez Arbonés, Javier (Hospital Arnau de Vilanova (Lleida, Catalunya))
Barril Farré, Sílvia (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Barbé, Ferran (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Hernández, Cristina (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)
Simó Canonge, Rafael (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)
Lecube, Albert (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)

Date:	2019
Abstract:	Introduction: Many studies on the impact of type 2 diabetes mellitus (T2DM) on sleep breathing have shown a higher prevalence and severity of sleep apnea-hypopnea syndrome (SAHS) in those with T2DM. Moreover, an increased activity of the sympathetic nervous system has been described in both pathologies. This cross-sectional study aimed to assess sympathetic activity in patients with T2DM, and to investigate the relationship between sympathetic activity and polysomnographic parameters. Materials and Methods: Thirty-six patients with T2DM without known clinical macrovascular nor pulmonary disease and 11 controls underwent respiratory polygraphy, and their cardiac variability and 24-h urine total metanephrines were measured. Results: SAHS was highly prevalent with a mean apnea-hypopnea index (AHI) in the range of moderate SAHS. In patients with T2DM, the nocturnal concentration of total metanephrines in urine were higher than diurnal levels [247. 0 (120. 0-1375. 0) vs. 210. 0 (92. 0-670. 0), p = 0. 039]. The nocturnal total metanephrine concentration was positively and significantly associatedwith the percentage of sleeping time spent with oxygen saturation <90%(CT90). In the entire population and in subjects with T2DM, the multivariate regression analysis showed a direct interaction between the nocturnal concentration of urine metanephrines and the CT90. Conclusion: These findings suggest that the increase in sympathetic activity previously described in patients with T2DM could be mediated through nocturnal breathing disturbances. The diagnosis and treatment of SAHS may influence sympathetic activity disorders and may contribute to an improvement in T2DM and cardiovascular risk.
Grants:	Instituto de Salud Carlos III PI12-00803 Instituto de Salud Carlos III PI15-00260
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Frontiers in endocrinology, Vol. 10 (january 2019) , p. 752, ISSN 1664-2392

DOI: 10.3389/fendo.2019.00752
PMID: 31736881

7 p, 278.4 KB

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