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Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study.

TitleSleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study.
Publication TypeJournal Article
Year of Publication2004
AuthorsPunjabi, NM, Shahar, E, Redline, S, Gottlieb, DJ, Givelber, R, Resnick, HE
Corporate/Institutional AuthorsSleep Heart Health Study Investigators,
JournalAm J Epidemiol
Volume160
Issue6
Pagination521-30
Date Published2004 Sep 15
ISSN0002-9262
KeywordsAged, Blood Gas Analysis, Body Constitution, Body Mass Index, Cohort Studies, Confounding Factors, Epidemiologic, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Fasting, Female, Glucose Intolerance, Glucose Tolerance Test, Humans, Insulin Resistance, Linear Models, Male, Middle Aged, Multivariate Analysis, Oxyhemoglobins, Polysomnography, Research Design, Risk Factors, Severity of Illness Index, Sleep Apnea Syndromes
Abstract<p>Clinic-based studies suggest that sleep-disordered breathing (SDB) is associated with glucose intolerance and insulin resistance. However, in the available studies, researchers have not rigorously controlled for confounding variables to assess the independent relation between SDB and impaired glucose metabolism. The objective of this study was to determine whether SDB was associated with glucose intolerance and insulin resistance among community-dwelling subjects (n=2,656) participating in the Sleep Heart Health Study (1994-1999). SDB was characterized with the respiratory disturbance index and measurements of oxygen saturation during sleep. Fasting and 2-hour glucose levels measured during an oral glucose tolerance test were used to assess glycemic status. Relative to subjects with a respiratory disturbance index of less than 5.0 events/hour (the reference category), subjects with mild SDB (5.0-14.9 events/hour) and moderate to severe SDB (> or =15 events/hour) had adjusted odds ratios of 1.27 (95% confidence interval: 0.98, 1.64) and 1.46 (95% confidence interval: 1.09, 1.97), respectively, for fasting glucose intolerance (p for trend < 0.01). Sleep-related hypoxemia was also associated with glucose intolerance independently of age, gender, body mass index, and waist circumference. The results of this study suggest that SDB is independently associated with glucose intolerance and insulin resistance and may lead to type 2 diabetes mellitus.</p>
DOI10.1093/aje/kwh261
Alternate JournalAm J Epidemiol
PubMed ID15353412
Grant ListHL075078 / HL / NHLBI NIH HHS / United States
U01HL53940 / HL / NHLBI NIH HHS / United States
U01HL53941 / HL / NHLBI NIH HHS / United States
UO1HL53916 / HL / NHLBI NIH HHS / United States
UO1HL53931 / HL / NHLBI NIH HHS / United States
UO1HL53934 / HL / NHLBI NIH HHS / United States
UO1HL53937 / HL / NHLBI NIH HHS / United States
UO1HL53938 / HL / NHLBI NIH HHS / United States
UO1HL63429 / HL / NHLBI NIH HHS / United States
UO1HL63463 / HL / NHLBI NIH HHS / United States