Effects of obstructive sleep apnea syndrome on dyslipidemia and carotid atherosclerosis in patients with type 2 diabetes mellitus
LIU Ran1,ZHANG Lei2,LI Chunlin3,FANG Yi1,WANG Jinjing1,ZENG Jing1,and LIU Huiying4
1.Department of Endocrinology, 4. Department of Respiration, Hospital 307 of PLA, Beijing 100071,China; 2. Department of Emergency, General Hospital of Rocket Force,Beijing 100088,China; 3.Department of Carders, Hospital 316 of PLA,100093,China
Abstract：Objective To study the influence of obstructive sleep apnea syndrome(OSAS) on dyslipidemia and carotid atherosclerosis in patients with type 2 diabetes mellitus.Methods Eligible inpatients with type 2 diabetes in PLA Hospital307 were selected, who were monitored by ResMedApneaLinkTM Plus portable sleep testing devices. These patients were classified into the mild, moderate and severe OSAS groups according to the apnea-hypopnea index(AHI). All these patients underwent carotid artery ultrasound scan, and their disease course information and baseline parameters including age, waist circumference, body mass index(BMI) and mean artery pressure(MAP) were recorded. Their blood samples were also collected for laboratory tests of hemoglobin A1c(HbA1c), fasting blood glucose(FBG), 2-hour postprandial blood glucose, total cholesterol(TC), triglyceride(TG), high-density lipoprotein-cholesterol(HDL-C) and low-density lipoprotein-cholesterol(LDL-C).Results There were 106 patients who completed all the tests, 71 of whom were combined with OSAS(67%), with 36, 19 and 16 patients in the mild, moderate and severe OSAS groups respectively. OSAS patients had higher levels of TC[(5.16±1.04)mmol/L vs(4.68±1.13)mmol/L,P<0.05],TG[(2.57±1.27)mmol/L vs (1.81±0.78) mmol/L],P<0.05) and LDL-C[(2.78±0.76)mmol/L vs (2.34±0.82) mmol/L],P<0.05),but lower levels of HDL-C[(1.21±0.45)mmol/L vs (1.43±0.34) mmol/L],P<0.05)than non-OSAS patients. There were far more cases of carotid atherosclerosis in OSAS group than in non-OSAS group (62.0% vs 31.4%, P<0.05). Multivariate logistic regression analysis revealed that LDL-C levels(OR1.19, 95%CI 1.07-1.21, P<0.05) and apnea-hypopnea index(AHI)(OR 1.13, 95%CI 0.89-1.14, P<0.05) were independently related to the incidence of carotid atherosclerosis.Conclusions Patients with type 2 diabetes mellitus combined with OSAS are susceptible to more severe dyslipidemia, and high levels of LDL-C and OSAS severity are independently related to the incidence of carotid atherosclerosis.
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2017, Vol. 28 
