Relationship Between AHI And CVD Risk Factors In T2DM Patients

Objective:To explore the relationship between the AHI and the risk factors of CVD in patients with T2DM.Research methods:From September 2020 to March 2022,we conducted 216 T2DM patients who were hospitalized in the endocrinology department of our hospital,and volunteered to participate in the study,all the patients were monitored by polysomnography at night.According to AHI,they were divided into three groups,group A(Without merging OSAHS):AHI<5(n=49,22.69%),group B1(Combined mild and moderate OSAHS):5≤AHI≤30(n=119,55.09%),group B2(Combined severe OSAHS):AHI>30(n=48,22.22%).The basic information of patients’sex,age,diabetes duration,and smoking were collected,and SBP,DBP,height,weight,and BMI were measured.Fasting venous blood was collected for the detection of Hcy,ALT,AST,GGT,UA,FPG,FINS,calculated HOMA-IR,Hb A1c,CHOL,TG,LDL-C,HDL-C,and TG/HDL-C ratio were calculated.Results:1.There were no significant differences in age,gender,diabetes duration,smoking,Hb A1c,AST,HDL-C,LDL-C,and CHOL among the three groups(P>0.05).The level of BMI,SBP,DBP,ALT,GGT,FPG,HOMA-IR,TG,TG/HDL-C ratio,UA and Hcy in group B2were higher than group B1,all with significant differences(P<0.05).The level of BMI,HOMA-IR,and GGT in group B1 were significantly higher than group A,(P<0.05).There were no significant differences in SBP,DBP,FPG,TG,TG/HDL-C ratio,ALT,Hcy,UA between group B1 and group A(P>0.05).2.Pearson correlation analysis:AHI was positively correlated with BMI(r=0.673,P=0.000),HOMA-IR(r=0.735,P=0.000),GGT(r=0.350,P=0.000),ALT(r=0.269,P=0.000),AST(r=0.134,P=0.049),TG/HDL-C ratio(r=0.288,P=0.000),TG(r=0.234,P=0.001),Hcy(r=0.225,P=0.001),SBP(r=0.230,P=0.001),DBP(r=0.180,P=0.008),FPG(r=0.200,P=0.003),UA(r=0.191,P=0.005),and negatively correlated with HDL-C(r=-0.166,P=0.015).3.Linear regression model analysis:Model 1:AHI was independently associated with HOMA-IR(R~2=0.540,P=0.000),TG/HDL-C ratio(R~2=0.091,P=0.000),TG(R~2=0.061,P=0.000),SBP(R~2=0.053,P=0.001),FPG(R~2=0.037,P=0.000),Hcy(R~2=0.023,P=0.017),GGT(R~2=0.018,P=0.025).Conclusion:With the increase of AHI,CVD risk factors of T2DM patients,the level of BMI,blood pressure,FPG,HOMA-IR,TG,TG/HDL-C ratio,liver enzyme,UA,Hcy increased more significantly.In addition to common CVD risk factors of interest,including BMI,blood pressure,FPG,HOMA-IR,and TG,AHI was also independently correlated with the TG/HDL-C ratios,Hcy,and GGT.Patients with T2DM should be routinely screened for OSAHS and aggressively corrected for hypoxemia,which in turn is expected to reduce the incidence and progression of CVD in patients with T2DM.