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Nocturnal hypoxemic burden and micro- and macrovascular disease in patients with type 2 diabetes

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Title: Nocturnal hypoxemic burden and micro- and macrovascular disease in patients with type 2 diabetes
Authors: Driendl, Sarah M., Stadler, Stefan, Arzt, Michael, Zeman, Florian, Heid, Iris M., Baumert, Mathias
Source: Cardiovasc Diabetol
Cardiovascular Diabetology, Vol 23, Iss 1, Pp 1-11 (2024)
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: Male, Time Factors, 610 Medizin, Hypoxia, Hypoxemic burden, Cardiovascular disease, Chronic kidney disease, Type 2 diabetes, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Chronic kidney disease, Diseases of the circulatory (Cardiovascular) system, Humans, Oximetry, Renal Insufficiency, Chronic, Hypoxia, Aged, ddc:610, Diabetes Mellitus, Type 2/epidemiology [MeSH], Hypoxia/diagnosis [MeSH], Renal Insufficiency, Chronic/physiopathology [MeSH], Type 2 diabetes, Renal Insufficiency, Chronic/diagnosis [MeSH], Aged [MeSH], Cardiovascular disease, Risk Factors [MeSH], Male [MeSH], Hypoxia/blood [MeSH], Diabetes Mellitus, Type 2/diagnosis [MeSH], Female [MeSH], Diabetes Mellitus, Type 2/complications [MeSH], Humans [MeSH], Renal Insufficiency, Chronic/blood [MeSH], Oxygen Saturation [MeSH], Middle Aged [MeSH], Cross-Sectional Studies [MeSH], Diabetes Mellitus, Type 2/blood [MeSH], Diabetic Angiopathies/physiopathology [MeSH], Diabetic Angiopathies/blood [MeSH], Time Factors [MeSH], Hypoxia/physiopathology [MeSH], Hypoxemic burden, Diabetic Angiopathies/diagnosis [MeSH], Research, Hypoxia/epidemiology [MeSH], Circadian Rhythm [MeSH], Renal Insufficiency, Chronic/epidemiology [MeSH], Oximetry [MeSH], Diabetic Angiopathies/epidemiology [MeSH], Middle Aged, Circadian Rhythm, 3. Good health, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Oxygen Saturation, RC666-701, Female, Diabetic Angiopathies
Description: Background Micro- and macrovascular diseases are common in patients with type 2 diabetes mellitus (T2D) and may be partly caused by nocturnal hypoxemia. The study aimed to characterize the composition of nocturnal hypoxemic burden and to assess its association with micro- and macrovascular disease in patients with T2D. Methods This cross-sectional analysis includes overnight oximetry from 1247 patients with T2D enrolled in the DIACORE (DIAbetes COhoRtE) study. Night-time spent below a peripheral oxygen saturation of 90% (T90) as well as T90 associated with non-specific drifts in oxygen saturation (T90non − specific), T90 associated with acute oxygen desaturation (T90desaturation) and desaturation depths were assessed. Binary logistic regression analyses adjusted for known risk factors (age, sex, smoking status, waist-hip ratio, duration of T2D, HbA1c, pulse pressure, low-density lipoprotein, use of statins, and use of renin-angiotensin-aldosterone system inhibitors) were used to assess the associations of such parameters of hypoxemic burden with chronic kidney disease (CKD) as a manifestation of microvascular disease and a composite of cardiovascular diseases (CVD) reflecting macrovascular disease. Results Patients with long T90 were significantly more often affected by CKD and CVD than patients with a lower hypoxemic burden (CKD 38% vs. 28%, p p desaturation and desaturation depth were associated with CKD (adjusted OR 1.01 per unit, 95% CI [1.00; 1.01], p = 0.008 and OR 1.30, 95% CI [1.06; 1.61], p = 0.013, respectively) independently of other known risk factors for CKD. For CVD there was a thresholdeffect, and only severly and very severly increased T90non−specific was associated with CVD ([Q3;Q4] versus [Q1;Q2], adjusted OR 1.51, 95% CI [1.12; 2.05], p = 0.008) independently of other known risk factors for CVD. Conclusion While hypoxemic burden due to oxygen desaturations and the magnitude of desaturation depth were significantly associated with CKD, only severe hypoxemic burden due to non-specific drifts was associated with CVD. Specific types of hypoxemic burden may be related to micro- and macrovascular disease.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 1475-2840
DOI: 10.1186/s12933-024-02289-w
DOI: 10.5283/epub.58411
DOI: 10.1186/s12933-024-02289-w10.5283/epub.58411
Access URL: https://pubmed.ncbi.nlm.nih.gov/38844945
https://doaj.org/article/572d2239aa214010b12b2eea3902efce
https://repository.publisso.de/resource/frl:6524604
https://epub.uni-regensburg.de/58411/
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (http://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Accession Number: edsair.doi.dedup.....92572f91e91ceded0123325d616a023f
Database: OpenAIRE
Description
Abstract:Background Micro- and macrovascular diseases are common in patients with type 2 diabetes mellitus (T2D) and may be partly caused by nocturnal hypoxemia. The study aimed to characterize the composition of nocturnal hypoxemic burden and to assess its association with micro- and macrovascular disease in patients with T2D. Methods This cross-sectional analysis includes overnight oximetry from 1247 patients with T2D enrolled in the DIACORE (DIAbetes COhoRtE) study. Night-time spent below a peripheral oxygen saturation of 90% (T90) as well as T90 associated with non-specific drifts in oxygen saturation (T90non − specific), T90 associated with acute oxygen desaturation (T90desaturation) and desaturation depths were assessed. Binary logistic regression analyses adjusted for known risk factors (age, sex, smoking status, waist-hip ratio, duration of T2D, HbA1c, pulse pressure, low-density lipoprotein, use of statins, and use of renin-angiotensin-aldosterone system inhibitors) were used to assess the associations of such parameters of hypoxemic burden with chronic kidney disease (CKD) as a manifestation of microvascular disease and a composite of cardiovascular diseases (CVD) reflecting macrovascular disease. Results Patients with long T90 were significantly more often affected by CKD and CVD than patients with a lower hypoxemic burden (CKD 38% vs. 28%, p p desaturation and desaturation depth were associated with CKD (adjusted OR 1.01 per unit, 95% CI [1.00; 1.01], p = 0.008 and OR 1.30, 95% CI [1.06; 1.61], p = 0.013, respectively) independently of other known risk factors for CKD. For CVD there was a thresholdeffect, and only severly and very severly increased T90non−specific was associated with CVD ([Q3;Q4] versus [Q1;Q2], adjusted OR 1.51, 95% CI [1.12; 2.05], p = 0.008) independently of other known risk factors for CVD. Conclusion While hypoxemic burden due to oxygen desaturations and the magnitude of desaturation depth were significantly associated with CKD, only severe hypoxemic burden due to non-specific drifts was associated with CVD. Specific types of hypoxemic burden may be related to micro- and macrovascular disease.
ISSN:14752840
DOI:10.1186/s12933-024-02289-w