PMID- 19262746
OWN - NLM
STAT- MEDLINE
DCOM- 20090618
LR  - 20240326
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 4
IP  - 3
DP  - 2009
TI  - Diabetes is an independent risk factor for severe nocturnal hypoxemia in obese 
      patients. A case-control study.
PG  - e4692
LID - 10.1371/journal.pone.0004692 [doi]
LID - e4692
AB  - BACKGROUND: Type 2 diabetes mellitus (T2DM) and obesity have become two of the 
      main threats to public health in the Western world. In addition, obesity is the 
      most important determinant of the sleep apnea-hypopnea syndrome (SAHS), a 
      condition that adversely affects glucose metabolism. However, it is unknown 
      whether patients with diabetes have more severe SAHS than non-diabetic subjects. 
      The aim of this cross-sectional case-control study was to evaluate whether obese 
      patients with T2DM are more prone to severe SAHS than obese non-diabetic 
      subjects. METHODOLOGY/PRINCIPAL FINDINGS: Thirty obese T2DM and 60 non-diabetic 
      women closely matched by age, body mass index, waist circumference, and smoking 
      status were recruited from the outpatient Obesity Unit of a university hospital. 
      The exclusion criteria included chronic respiratory disease, smoking habit, 
      neuromuscular and cerebrovascular disease, alcohol abuse, use of sedatives, and 
      pregnancy. Examinations included a non-attended respiratory polygraphy, pulmonary 
      function testing, and an awake arterial gasometry. Oxygen saturation measures 
      included the percentage of time spent at saturations below 90% (CT90). A high 
      prevalence of SAHS was found in both groups (T2DM:80%, nondiabetic:78.3%). No 
      differences in the number of sleep apnea-hypopnea events between diabetic and 
      non-diabetic patients were observed. However, in diabetic patients, a 
      significantly increase in the CT90 was detected (20.2+/-30.2% vs. 6.8+/-13,5%; p 
      = 0.027). In addition, residual volume (RV) was significantly higher in T2DM 
      (percentage of predicted: 79.7+/-18.1 vs. 100.1+/-22.8; p<0.001). Multiple linear 
      regression analyses showed that T2DM but not RV was independently associated with 
      CT90. CONCLUSIONS/SIGNIFICANCE: T2DM adversely affects breathing during sleep, 
      becoming an independent risk factor for severe nocturnal hypoxemia in obese 
      patients. Given that SAHS is a risk factor of cardiovascular disease, the 
      screening for SAHS in T2DM patients seems mandatory.
FAU - Lecube, Albert
AU  - Lecube A
AD  - CIBER de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Instituto de 
      Salud Carlos III (ISCIII), Diabetes and Metabolism Research Unit, Institut de 
      Recerca Hospital Universitari Vall d'Hebron, Barcelona, Spain. 
      alecube@vhebron.net
FAU - Sampol, Gabriel
AU  - Sampol G
FAU - Lloberes, Patricia
AU  - Lloberes P
FAU - Romero, Odile
AU  - Romero O
FAU - Mesa, Jordi
AU  - Mesa J
FAU - Hernandez, Cristina
AU  - Hernandez C
FAU - Simo, Rafael
AU  - Simo R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090305
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Case-Control Studies
MH  - *Diabetes Complications
MH  - Diabetes Mellitus, Type 2/complications
MH  - Female
MH  - Humans
MH  - Hypoxia/*etiology
MH  - Obesity/*complications
MH  - Risk Factors
MH  - Sleep Apnea Syndromes/*etiology
PMC - PMC2650786
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2009/03/06 09:00
MHDA- 2009/06/19 09:00
PMCR- 2009/03/05
CRDT- 2009/03/06 09:00
PHST- 2008/12/08 00:00 [received]
PHST- 2009/01/18 00:00 [accepted]
PHST- 2009/03/06 09:00 [entrez]
PHST- 2009/03/06 09:00 [pubmed]
PHST- 2009/06/19 09:00 [medline]
PHST- 2009/03/05 00:00 [pmc-release]
AID - 08-PONE-RA-07650R1 [pii]
AID - 10.1371/journal.pone.0004692 [doi]
PST - ppublish
SO  - PLoS One. 2009;4(3):e4692. doi: 10.1371/journal.pone.0004692. Epub 2009 Mar 5.