Screening And Risk Factors Analysis Of Obstructive Sleep Apnea Hypopnea Syndrome In Patients With Type 2 Diabetes Mellitus

Background & Objective The incidence of obstructive sleep apnea hypopnea syndrome(OSAHS)in patients with type 2 diabetes mellitus(T2DM)is higher than that in non-diabetic patients.Long-term and chronic hypoxia at high altitudes may increase the risk of OSAHS.However,the prevalence and risk factors for OSAHS in patients with high-altitude T2 DM remain unclear.Based on Tibet's special geographical environment and medical conditions,we try to find a simple evaluation method and instrument by exploring its risk factors.The purpose of this study was to compare the screening instruments and diagnostic instruments for the diagnosis of OSAHS,and to assess the prevalence of OSAHS in hospitalized T2 DM patients in Tibet and to explore the associated risk factors.Methods The results showed that when the AHI value was greater than 9.1,the sensitivity of the screening instrument was 73.1%,the specificity was 100%,and the AUC curve area was 91.6%,P < 0.001.Tibetan type 2 diabetic patients hospitalized in the Department of Endocrinology and Metabolism,People's Hospital of Tibet Autonomous Region were invited to participate in the study.A portable monitoring device was used to detect the presence of obstructive sleep apnea hypopnea syndrome.The night apnea-hypopnea index(AHI)was recorded to assess the severity of OSAHS.Multivariate logisticregression model was used to evaluate the risk factors of type 2 diabetes mellitus with OSAHS.Multiple linear regression model was used to analyze whether domestic visceral fat index(CVAI)and waist circumference were the factors affecting AHI,P <0.05 was considered as statistically significant.The area under the curve(AUC)was calculated using the receiver operating characteristic curve(ROC)to analyze the accuracy of the portable monitoring device(Apnea Link TM,Res Med,San Diego,CA,USA)in the diagnosis of OSAHS in Tibetan patients with type 2 diabetes.Results In this study,79.32%(95% confidence interval:73.18-84.61%)of patients with T2 DM in the People's Hospital of Tibet Autonomous Region had OSAHS(AHI ? 5).None of the patients diagnosed were previously diagnosed with OSAHS.Waist circumference and CVAI are risk factors for Tibetan type 2 diabetes with OSAHS.According to multiple regression analysis,CVAI and waist circumference were the influencing factors of AHI,which increased with the severity of OSAHS and were independently associated with AHI(both P < 0.05).Portable monitoring devices have high accuracy in diagnosing OSAHS.Conclusion The prevalence of OSAHS is higher in T2 DM patients in Tibetan plateau,and the Tibetan population generally lacks knowledge of OSAHS.Visceral fat obesity(CVAI and waist circumference)is a risk factor for OSAHS in T2 DM patients in Tibetan plateau.Portable monitoring devices have high accuracy in diagnosing OSAHS and can bepromoted to primary hospitals.