FP17-1 Absence of Sex Disparity in the Prevalence of Obstructive Sleep Apnea in Type 2 Diabetes Mellitus

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: FP17-Diabetes: New Diagnostic & Treatment Modalities
Sunday, June 16, 2013: 10:45 AM-11:15 AM
Presentation Start Time: 10:45 AM
Room 307 (Moscone Center)

Poster Board SUN-807
Guglielmo Beccuti*, Daniela Grimaldi, Esra Tasali, Varghese Abraham, Harry Whitmore, David A Ehrmann, Eve Van Cauter and Babak Mokhlesi
The University of Chicago, Chicago, IL
Obstructive sleep apnea (OSA) is one of most prevalent comorbidities in type 2 diabetes mellitus (T2DM), with a reported prevalence of up to 86% in obese patients with T2DM. In community-based studies, there is a sex disparity in OSA prevalence, where OSA is 2- to 3-fold more likely to be present in men than in women. The aim of our study was to assess the prevalence of OSA in a cohort of patients with T2DM and to examine sex differences.

Patients with T2DM were consecutively recruited from the Chicago community. All the participants underwent overnight polysomnography. The presence of OSA was defined by an apnea-hypopnea index (AHI) >5 events/hour. Hypopnea was defined as a 50% reduction of airflow for at least 10 seconds on a semiquantitative signal that was associated with either a 3% or greater oxygen desaturation or a cortical microarousal on the electroencephalography. The severity of OSA was graded according to commonly used clinical cutoffs as follows: no OSA (AHI < 5); mild OSA (5 < AHI < 15); moderate OSA (15 < AHI < 30); and severe OSA (AHI > 30).

A total of 115 subjects were studied: 50 men and 65 women. No sex difference was observed for age (mean ± SD; men: 56.2 ± 10.1 years; women: 54.3 ± 9.5 years), HbA1c levels (men: 7.3% ± 1.7; women: 7.4% ± 1.7), number of antidiabetic medications, insulin use, years of diabetes, and exercise levels. Compared to men, women had a higher body mass index (BMI) (men: 33.0 ± 7.1 kg/m2; women: 35.7 ± 7.5 kg/m2; p = 0.035) and were at higher risk for T2DM based on ethnicity (men: 46%; women: 77%; p < 0.01).

Out of the total of 115 patients, 98 had OSA (AHI >5), thus the overall OSA prevalence was 85%. Even after controlling for BMI and ethnicity, there was no sex difference in OSA prevalence, with 88% of men and 83% of women having OSA, respectively. When comparing men and women with OSA, there was a trend for lower severity of disease in women (mild OSA: men 23%, female 38%; moderate OSA: men 32%, female 35%; severe OSA: men 45%, female 26%; p = 0.09).

In conclusion, our study confirms that the prevalence of OSA, a well-documented risk factor for insulin resistance and cardiovascular disease, is exceptionally high in T2DM and indicates that the sex disparity in OSA prevalence that is found in non-diabetic populations is no longer present in obese subjects with T2DM. This observation suggests that OSA may be on the causal pathway leading to T2DM development.

Nothing to Disclose: GB, DG, ET, VA, HW, DAE, EV, BM

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: This work was supported by NIH grants P50-HD057796, R01 HL075079, P60-DK020595, UL1-TR000430, PO1-AG11412, the Blum-Kovler Family Foundation and the ResMed Foundation.
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