Relationship Of Obstructive Sleep Apnea Hypopnea Syndrome And Early Diabetic Nephropathy

Objective:To analyze the relationship between obstructive sleep apnea hypopnea syndrome(OSAHS)and early diabetic nephropathy(EDN).Methods:Totally 148 patients with type 2 diabetes from department of endocrinology,China-Japan Union Hospital of Jilin University from September 2015 to February 2018 were enrolled in our study.Record all selected patients' general data objects including age,gender,course of diabetes,weight,height;record biochemical indexes,including glycosylated hemoglobin,renal function,Cys-C,24hUAE and other indicators,then undergo polysomnography and record all patients' AHI,LSaO2 and MSaO2.According to AHI,the subjects were divided into 4 groups,less than 5 times of which pure T2DM group,5 to 15 times of which mild group,16 to 30 times of which moderate group;more than 30 times of which severe group.The difference of general clinical data and biochemical indexes between the four groups was compared,and the risk factors of early diabetic nephropathy were analyzed by multiple logistics regression analysis.Results:(1)148 subjects(male/female,77/71),of which 33 cases' AHI(22.3%)were below 5 times,30 cases' AHI(20.3%)were between 5 and 14 times,45 cases' AHI(30.4%)were between 15 and 29 times,and 45 cases' AHI(30.4%)were more than 30 times.(2)Single factor analysis of variance showed that the levels of 24hUAE,CRP and Cys-C in OSAHS patients were all higher than those in simple T2DM group,and the indexes increased with the aggravation of OS AHS condition.The BMI of mild and moderate group is higher than other groups.The duration of diabetes mellitus,HbAlc and AHI in group EDN were higher than those in non DN group,while the lowest blood oxygen saturation(LSaO2)at night was lower than that in non DN group.The difference was statistically significant.(3)Multiple Logistics regression analysis showed that the course of diabetes,HbAlc and AHI are positively correlated with the occurrence of EDN,and LSaO2 is negatively correlated with the occurrence of EDN.Conclusion:(1)OSAHS is an independent risk factor for EDN,Patients with T2DM combined with OS AHS developed EDN earlier.(2)With the aggravation of OSAHS,the higher the level of 24hUAE,CRP and Cys-C in T2DM patients,the more severe the kidney injury.