Obstructive Sleep Apnea, Resting Heart Rate, and Glycemic Variability in Adults With Maturity-Onset Diabetes of the Young

Obstructive sleep apnea (OSA) is a common condition strongly linked to increased cardiovascular risk and poor glycemic control. Little is known about OSA, cardiovascular risk, and glycemia in maturity-onset diabetes of the young (MODY), an inherited form of diabetes, which is different than both type 1 and type 2 diabetes. We assessed OSA, resting heart rate (RHR), an important prognostic marker of cardiovascular disease, and glycemic variability among the most common subtypes of MODY, glucokinase (GCK)-MODY, and transcription factor (TF)-related MODY (HNF1A, HNF4A, and HNF1B). Adults with GCK-MODY (n = 63) and TF-related MODY (n = 60) and control adults without diabetes (n = 65) were screened for OSA by home sleep test. Glycemic variability (continuous glucose monitoring) and RHR (wearable sleep-activity tracker) were concomitantly assessed for 2 weeks at home. Data from 188 individuals (2,853 recorded days) were analyzed. Individuals with TF-related MODY, compared with those with GCK-MODY or control individuals, had more OSA (48.3%, 27.0%, and 30.8%, respectively; P = 0.033), higher RHR (72.8 ± 10.8, 65.2 ± 7.9, and 67.3 ± 7.7 bpm, respectively; P < 0.001), and higher glycemic variability (coefficient of variation of glucose 31.6 ± 6.0%, 17.3 ± 4.5%, and 17.5 ± 4.0%, respectively; P < 0.001). Greater severity of OSA and higher RHR were associated with higher glycemic variability. These findings may have important clinical implications for cardiovascular risk assessment in MODY. ARTICLE HIGHLIGHTS: Obstructive sleep apnea (OSA) has been strongly linked to increased cardiovascular risk and poor glycemic control in the general population. Resting heart rate (RHR) is a prognostic marker of cardiovascular morbidity and mortality and has been linked to dysglycemia. Little is known about OSA, RHR, and glycemia in maturity-onset diabetes of the young (MODY), an inherited form of diabetes with discrete clinical features. Adults with transcription factor-related MODY (HNF1A, HNF4A, and HNF1B) had more OSA and higher RHR and greater glycemic variability compared with those with glucokinase-MODY or control adults without diabetes, which may have important clinical implications for future cardiovascular risk.