High-risk obstructive sleep apnea in Type 1 Diabetes Mellitus was independently associated with microvascular complications compared to low-risk OSA (OR 5.55; 95% CI 1.36-22.65; p=0.017).
Case-Control (n=228)
Is high-risk obstructive sleep apnea associated with microvascular complications in adults with Type 1 Diabetes Mellitus?
High-risk OSA is independently associated with a more than 5-fold increased odds of microvascular complications in adults with Type 1 Diabetes Mellitus.
Effect estimate: OR 5.55 (95% CI 1.36-22.65)
Absolute Event Rate: 68.4% vs 18.07%
p-value: p=0.017
Background: Obstructive sleep apnea (OSA) is a common but underrecognized sleep-related breathing disorder characterized by intermittent hypoxemia and autonomic dysfunction. OSA prevalence and clinical relevance in Type 1 Diabetes Mellitus (T1DM), particularly in relation to diabetes-related vascular complications, remain insufficiently explored. Objective: The aim of this study was to evaluate the prevalence of high-risk OSA in adults with T1DM and controls, and to investigate the association between high-risk OSA and microvascular complications among individuals with T1DM. Methods: In this cross-sectional case–control study, 102 adults with T1DM and 126 controls were included. OSA risk was assessed using the modified Berlin Questionnaire (mBQ). Analyses of vascular complications were restricted to participants with T1DM. Multivariable logistic regression models adjusted for age and sex were used to assess associations, with additional adjustments for body mass index, hypertension, current smoking, alcohol use and glycated hemoglobin A1c. Results: High-risk OSA was identified in 18.6% of individuals with T1DM and 11.9% of controls, with no significant difference between groups. Among participants with T1DM, the prevalence of microvascular complications (retinopathy and/or neuropathy) was substantially higher in those with high-risk OSA compared with those at low risk (68.4% vs. 18.07%, p <0.001). In univariate logistic regression analysis, high-risk OSA was significantly associated with microvascular complications (odds ratio OR 4.85; 95% confidence interval CI 1.65–14.24; p = 0.004). This association remained significant in the fully adjusted model (OR 5.55; 95% CI 1.36–22.65; p = 0.017). Conclusions: High-risk OSA is not more prevalent in adults with T1DM compared with controls; however, among individuals with T1DM, high-risk OSA is strongly and independently associated with microvascular complications. Given the potential contribution of diabetic microvascular and autonomic neuropathy to upper airway dysfunction, the relationship between OSA and vascular complications in T1DM may be bidirectional, warranting further longitudinal investigation.
Demir et al. (Fri,) conducted a case-control in Type 1 Diabetes Mellitus (n=228). High-risk Obstructive Sleep Apnea (OSA) vs. Low-risk OSA was evaluated on Microvascular complications (retinopathy and/or neuropathy) (OR 5.55, 95% CI 1.36-22.65, p=0.017). High-risk obstructive sleep apnea in Type 1 Diabetes Mellitus was independently associated with microvascular complications compared to low-risk OSA (OR 5.55; 95% CI 1.36-22.65; p=0.017).