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. 2021 Dec;44(12):2741-2748.
doi: 10.1007/s40618-021-01602-8. Epub 2021 Jun 26.

Postprandial glucose and HbA1c are associated with severity of obstructive sleep apnoea in non-diabetic obese subjects

A Cignarelli  1 , A Ciavarella  1 , M Barbaro  1 , S Kounaki  1 , A Di Trani  1 , V A Falcone  2 , V N Quaranta  2 , A Natalicchio  1 , L Laviola  1 , O Resta  2 , F Giorgino  3 , S Perrini  1
Affiliations

Postprandial glucose and HbA1c are associated with severity of obstructive sleep apnoea in non-diabetic obese subjects

A Cignarelli et al. J Endocrinol Invest. 2021 Dec.

Abstract

Introduction: Obstructive sleep apnoea (OSA) is an underdiagnosed condition frequently associated with glycaemic control impairment in patients with type 2 diabetes.

Aim: To assess the relationship between glycometabolic parameters and OSA in obese non-diabetic subjects.

Methods: Ninety consecutive subjects (mean age 44.9 ± 12 years, mean BMI 42.1 ± 9 kg/m2) underwent polysomnography and a 2-h oral glucose tolerance test (OGTT).

Results: OSA was identified in 75% of subjects, with a higher prevalence of males compared to the group of subjects without OSA (62% vs 32%, p = 0.02). Patients with OSA had comparable BMI (42.8 kg/m2 vs 39.4 kg/m2), a higher average HbA1c (5.8% vs 5.4%, p < 0.001), plasma glucose at 120 min during OGTT (2 h-PG; 123 mg/dl vs 97 mg/dl, p = 0.009) and diastolic blood pressure (81.1 mmHg vs 76.2 mmHg, p = 0.046) than obese subjects without OSA. HbA1c and 2 h-PG were found to be correlated with the apnoea-hypopnoea index (AHI; r = 0.35 and r = 0.42, respectively) and with percent of sleep time with oxyhaemoglobin saturation < 90% (ST90; r = 0.44 and r = 0.39, respectively). Further, in a linear regression model, ST90 and AHI were found to be the main determinants of 2 h-PG (β = 0.81, p < 0.01 and β = 0.75, p = 0.02, respectively) after controlling for age, sex, waist circumference, physical activity, and C-reactive protein. Similarly, ST90 and AHI persisted as independent determinants of HbA1c (β = 0.01, p = 0.01 and β = 0.01, p = 0.01, respectively).

Conclusion: Beyond the traditional clinical parameters, the presence of a normal-high value of 2 h-PG and HbA1c should raise suspicion of the presence of OSA in obese subjects.

Keywords: Fasting; Glycemia; Obesity; Postprandial; Sleep apnea.

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Glycaemic parameters according to tertiles of apnoeic indexes. A–C FPG, 2 h-PG and HbA1c boxplots according to AHI tertiles, respectively. D–F FPG, 2 hPG and HbA1c boxplots according to ST90 tertiles, respectively. Abbreviations: AHI Apnoea-hypopnoea index, ST90 % of sleep time spent below 90% oxygen saturation, FPG Fasting plasma glucose, 2 h-PG Postprandial glucose 2 hours after oral glucose tolerance test, HbA1c Glycated haemoglobin A1c
See this image and copyright information in PMC

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