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- Title
Associations between Obstructive Sleep Apnea, Sleep Duration, and Abnormal Fasting Glucose. The Multi-Ethnic Study of Atherosclerosis.
- Authors
Bakker, Jessie P.; Jia Weng; Rui Wang; Redline, Susan; Punjabi, Naresh M.; Patel, Sanjay R.; Weng, Jia; Wang, Rui
- Abstract
<bold>Rationale: </bold>No data exist as to the role of ethnicity in the associations between obstructive sleep apnea (OSA), sleep duration, and metabolic dysfunction.<bold>Objectives: </bold>To examine links between OSA, objectively measured habitual sleep duration, and fasting glucose in U.S. ethnic groups.<bold>Methods: </bold>The Multi-Ethnic Study of Atherosclerosis is a multisite community-based study that conducted polysomnography and wrist actigraphy. In 2,151 subjects (1,839 in fully adjusted models), the apnea-hypopnea index was used to classify OSA as none (0-4.9/h), mild (5-14.9/h), or moderate to severe (≥15/h). Actigraphic sleep duration was classified as short (≤5 h/night), intermediate (>5 and <8 h/night), or long (≥8 h/night). Subjects were classified as having normal fasting glucose (<100 mg/dl and no hypoglycemic medication use) or abnormal fasting glucose (≥100 mg/dl and/or hypoglycemic medication use).<bold>Measurements and Main Results: </bold>The sample was 45.8% male, age 68.5 ± 9.2 (mean ± SD) years, and 27.3% African American, 37.2% white, 11.8% Chinese, and 23.8% Hispanic. The prevalence of abnormal fasting glucose was 40.2%. Relative to subjects without apnea, moderate-to-severe OSA was significantly associated with abnormal fasting glucose in African Americans (odds ratio, 2.14; 95% confidence interval, 1.12-4.08) and white participants (odds ratio, 2.85; 95% confidence interval, 1.20-6.75), but not among Chinese or Hispanic subjects, after adjusting for site, age, sex, waist circumference, and sleep duration (P = 0.06 for ethnicity-by-OSA severity interaction). In contrast, sleep duration was not significantly associated with abnormal fasting glucose after considering the influence of OSA.<bold>Conclusions: </bold>This large multiethnic study confirmed previous reports of an independent association between OSA and metabolic dysfunction, and suggested that this association may vary by ethnicity.
- Subjects
UNITED States; TYPE 2 diabetes diagnosis; ACTIGRAPHY; BLOOD sugar; LONGITUDINAL method; TYPE 2 diabetes; RESEARCH funding; SLEEP; SLEEP apnea syndromes; TIME; LOGISTIC regression analysis; POLYSOMNOGRAPHY; CROSS-sectional method; DISEASE complications
- Publication
American Journal of Respiratory & Critical Care Medicine, 2015, Vol 192, Issue 6, p745
- ISSN
1073-449X
- Publication type
journal article
- DOI
10.1164/rccm.201502-0366OC