Continuous Positive Airway Pressure Treatment, Glycemia, and Diabetes Risk in Obstructive Sleep Apnea and Comorbid Cardiovascular Disease

作者：Kelly A. Loffler, Emma Heeley, Ruth S. Freed, Rosie Meng, Lia Bittencourt, Carolina Gonzaga, Rui Chen, Michael Hlavac, Zhihong Liu, Geraldo Lorenzi‐Filho, Yuanming Luo, Nigel McArdle, Sutapa Mukherjee, Hooi Shan Yap, Xilong Zhang, Lyle J. Palmer, Craig S. Anderson, R. Doug McEvoy, Luciano F. Drager, SAVE Substudy Investigators, Maree Barnes, Fengchun Yu, Xiaomei Meng, Wei Liu, Xinping Chen, Xiaomei Tang, Gaohui Xiao, Maolin He, Jingjing Liu, Matt S. Naughton, Michelle Hooy, Sophie Yorkston, Michael Hlavac, Michael Epton, Malina Storer, Julie Margaret Cook, Alastair Corbett, Rosie Portley, Ben Brockway, Jan O. Cowan, D. Robin Taylor, Emma Cox, Rochelle Palmay, Alan A. Young, Sue Del Sasso, Irina Shinkarksy, Ilana Shinkarksy, Francis Thien, Denise M. O’Driscoll, Angela M. Anniss, Wei Wang, Hui Shen, Derek P. Chew, Frances Kissajukian, Kate Luscombe, Fiona Wollaston, Zhihong Liu, Qiong Ou, Baoliang Du, Yanxia Wang, Yanhua Guo, Wei Dong, Lixin Wu, Kunlun Yu, Shengli Wang, Junyan Shi, Luciano F. Drager, Gabriela A. Souza, Daniel B.C. Queiróz, Katherine Ferrier, Judy Dewar, Ria Kleintjes, J. L. Kovacs, Angela Campbell, Alister Neill, Yuechun Li, Xiue Li, Ruichun Pan, Hui Xue, Celso Amodeo, Juliana Silva, Renata Depizzol, Dalete de Andrade, Adriana Bertolami, Carolina Gonzaga, Geraldo Lorenzi‐Filho, Gabriela A. Souza, Daniel B.C. Queiróz, Lia Bittencourt, Carolina Baeta Neves Duarte Ferreira, Madga Bignotto, Zhiqing Pan, Yu Dou, Meiyu Zhu, Lu Gan, Margaret Arstall, William B. Jeffries, Naomi Lamberts, Garun S. Hamilton, Joanne E. McKenzie, Xiuwei Zhang, Yi Xiao, Rong Huang, R. Doug McEvoy, Nick A. Antic, Denzil Paul, Amanda McKenna, Craig Anderson, Candice Delcourt, Cheryl Carcel, Elizabeth Ray, T. Paraskevaidis, Sabrina Small, Huili Zhu, Yu‐Lu Liang, Min Li, Xinbing Liu, Minpeng Wang, Jiangtao Lin, Yiming Li, Neil M.H. Graham, Mary Elizabeth Molloy, Lie Wu, Xia Guo, Junping Wu, Qiang Li, Xiaohua Xu, Yuangming Luo, Zhihui Qiu, Xilong Zhang, Chong Li, Wanda Peng, Guocui Zhen, Jian Hong Liu, James Douglas, Nicola Dunn, D. Walters, Ling Lan, Jane E Mikli, Andrew Wong, Deanne Curtin, Jan Robinson, Liwen Tai, Huijuan Wang, Rui Chen, Yanqiu Sun, Yanyu He, Bei Wang, Zhuda Liu, Hui Zhao, Xiaoling Gao, Yanfeng Fan, Hanqiao Wang, Cat Chang, Christine Tuffery, Sandra Hopping, Nigel McArdle, Sutapa Mukherjee, Bernadett Boeing, David R. Hillman, Siobhan Clare Rea, Xue‐Jun Guo, Lianping Ren, Jinyuan Sun, Yi‐Ping Sun, Guangyue Qin, Shanqun Li, Wenjing Li, Xiaodan Wu, Jing Zhou, Hong Jiang, Laura Bandick, Michaela O'Keefe, Jeremy Mercer, Mark Jurisevic, Samantha Mead, Emma Heeley, Ruth S. Freed, Tina Cheung, Natalie Espinosa, S. Leighton, T. Sassé, Michelle Leroux, Ying Shu, Yuehan Zheng, Wei Wei, Hongyu Zhang, Jing Zhou, Haijing Jia, Meng Zhang, Buliang Cui, Hua Deng, Aiwu Song, R. Doug McEvoy, Craig Anderson, Ronald R. Grunstein, Jan Hedner, Shao-Guang Huang, Geraldo Lorenzi‐Filho, Bruce Neal, Lyle J. Palmer, Susan Redline, Ji‐Guang Wang, Nanshan Zhong · 发表于：Diabetes Care · 年份：2020 · DOI：10.2337/dc19-2006 · 被引用次数：54 · 研究领域：Obstructive Sleep Apnea Research、Tracheal and airway disorders、Restless Legs Syndrome Research

OBJECTIVE Despite evidence of a relationship among obstructive sleep apnea (OSA), metabolic dysregulation, and diabetes, it is uncertain whether OSA treatment can improve metabolic parameters. We sought to determine effects of long-term continuous positive airway pressure (CPAP) treatment on glycemic control and diabetes risk in patients with cardiovascular disease (CVD) and OSA. RESEARCH DESIGN AND METHODS Blood, medical history, and personal data were collected in a substudy of 888 participants in the Sleep Apnea cardioVascular Endpoints (SAVE) trial in which patients with OSA and stable CVD were randomized to receive CPAP plus usual care, or usual care alone. Serum glucose and glycated hemoglobin A1c (HbA1c) were measured at baseline, 6 months, and 2 and 4 years and incident diabetes diagnoses recorded. RESULTS Median follow-up was 4.3 years. In those with preexisting diabetes (n = 274), there was no significant difference between the CPAP and usual care groups in serum glucose, HbA1c, or antidiabetic medications during follow-up. There were also no significant between-group differences in participants with prediabetes (n = 452) or new diagnoses of diabetes. Interaction testing suggested that women with diabetes did poorly in the usual care group, while their counterparts on CPAP therapy remained stable. CONCLUSIONS Among patients with established CVD and OSA, we found no evidence that CPAP therapy over several years affects glycemic control in those with diabetes or predi...