The Effect Of Obstructive Sleep Apnea Hypopnea Syndrome On Retinopathy Of Type 2 Diabetic Patients

[Objective]This study aimed to explore the impact of obstructive sleep apnea hypopnea syndrome(OSAHS)on diabetic retinopathy(DR)in patients with type 2 diabetes.[Methods]We enrolled 173 patients with type 2 diabetes hospitalized in the Department of Endocrinology of the Third Affiliated Hospital of Soochow University from January 2016 to January 2021.The patient cohort were divided into simple type 2 diabetes group(DM group)and type 2 diabetes combined with OSAHS group(DO group)according to whether they were combined with OSAHS;DO group was further divided into mild OSAHS group(L-DO group),moderate OSAHS group(M-DO group)and severe OSAHS group(H-DO group)according to the severity of OSAHS.We compared the difference of general clinical parameters,biochemical indicators and DR prevalence among the different groups.We used Spearman correlation to analyze the correlation between DR and general clinical parameters,biochemical indicators and we used binary Logistic regression to analyze the influence factors of DR.[Results]The prevalence of DR in the DM group was significantly lower than that in the DO group(8%vs 20.33%,χ~2=3.870,P=0.049);The prevalence of DR in the L-DO group,M-DO group and H-DO group was 16.07%,31.03%and 18.42%,respectively(P>0.05).The age,body mass index,waist circumference,waist-to-hip ratio,diastolic blood pressure,fasting blood glucose,glycosylated hemoglobin,and low-density lipoprotein cholesterol levels in DO group were significantly higher than those in the DM group;There were differences in waist circumference and waist-to-hip ratio between the L-DO group,M-DO group and H-DO group,and the waist circumference and waist-to-hip ratio of the H-DO group were significantly higher than that of the L-DO group.Spearman correlation analysis showed that DR was positively correlated with the course of diabetes(P<0.001),and was correlated with the polysomnography index(minimum blood oxygen saturation,average blood oxygen saturation)negatively.Logistic regression analysis showed that the risk of DR increased with the decrease of the minimum blood oxygen saturation(OR=0.898,95%CI:0.844-0.955),and increased with the increase of the course of diabetes(OR=1.180,95%CI:1.086-1.282).[Conclusion]The risk of DR in patients with OSAHS in type 2 diabetes is significantly higher than that in patients with simple type 2 diabetes,and minimum blood oxygen saturation and the course of diabetes are independent risk factors for DR.