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. 2018 Oct 15;8(10):e022752.
doi: 10.1136/bmjopen-2018-022752.

Obstructive sleep apnoea and the risk for coronary heart disease and type 2 diabetes: a longitudinal population-based study in Finland

Satu Strausz  1   2   3 , Aki S Havulinna  3   4 , Tiinamaija Tuomi  3   5   6 , Adel Bachour  7 , Leif Groop  3   8 , Antti Mäkitie  9 , Seppo Koskinen  4 , Veikko Salomaa  4 , Aarno Palotie  3   10   11   12   13 , Samuli Ripatti #  3   14 , Tuula Palotie #  1   2
Affiliations

Obstructive sleep apnoea and the risk for coronary heart disease and type 2 diabetes: a longitudinal population-based study in Finland

Satu Strausz et al. BMJ Open. .

Abstract

Objective: To evaluate if obstructive sleep apnoea (OSA) modifies the risk of coronary heart disease, type 2 diabetes (T2D) and diabetic complications in a gender-specific fashion.

Design and setting: A longitudinal population-based study with up to 25-year follow-up data on 36 963 individuals (>500 000 person years) from three population-based cohorts: the FINRISK study, the Health 2000 Cohort Study and the Botnia Study.

Main outcome measures: Incident coronary heart disease, diabetic kidney disease, T2D and all-cause mortality from the Finnish National Hospital Discharge Register and the Finnish National Causes-of-Death Register.

Results: After adjustments for age, sex, region, high-density lipoprotein (HDL) and total cholesterol, current cigarette smoking, body mass index, hypertension, T2D baseline and family history of stroke or myocardial infarction, OSA increased the risk for coronary heart disease (HR=1.36, p=0.0014, 95% CI 1.12 to 1.64), particularly in women (HR=2.01, 95% CI 1.31 to 3.07, p=0.0012). T2D clustered with OSA independently of obesity (HR=1.48, 95% CI 1.26 to 1.73, p=9.11×[Formula: see text]). The risk of diabetic kidney disease increased 1.75-fold in patients with OSA (95% CI 1.13 to 2.71, p=0.013). OSA increased the risk for coronary heart disease similarly among patients with T2D and in general population (HR=1.36). All-cause mortality was increased by OSA in diabetic individuals (HR=1.35, 95% CI 1.06 to 1.71, p=0.016).

Conclusion: OSA is an independent risk factor for coronary heart disease, T2D and diabetic kidney disease. This effect is more pronounced even in women, who until now have received less attention in diagnosis and treatment of OSA than men.

Keywords: coronary heart disease; diabetic kidney disease; longitudinal; mortality; obstructive sleep apnea; type 2 diabetes.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Distributions of age at obstructive sleep apnoea (OSA) diagnosis (mean 55.31 years) and (B) significant differences in body mass index (BMI) (p = 3.49×10−96), (C) systolic blood pressure (p = 7.78×10−3) and (D) HDL (p = 8.98×10−53 among patients with OSA and non-OSA individuals in FINRISK.
See this image and copyright information in PMC

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