Resumen de Independent Association Between Obstructive Sleep Apnea Severity and Glycated Hemoglobin in Adults Without Diabetes

Pascaline Priou, Marc Le Vaillant, Nicole Meslier, Sylvaine Chollet, Philippe Masson, Marie P. Humeau, Thierry Pigeanne, Acya Bizieux- Thaminy, François Goupil, Frédéric Gagnadoux

• We tested the hypothesis of an independent cross-sectional association between obstructive sleep apnea (OSA) severity and glycated hemoglobin (HbA^sub 1c^) in adults without known diabetes. HbA^sub 1c^ was measured in whole-blood samples from 2,139 patients undergoing nocturnal recording for suspected OSA. Participants with self-reported diabetes, use of diabetes medication, or HbA^sub 1c^ value ?6.5% were excluded from this study. Our final sample size comprised 1,599 patients. A dose-response relationship was observed between apnea-hypopnea index (AHI) and the percentage of patients with HbA^sub 1c^ >6.0%, ranging from 10.8% for AHI <5 to 34.2% for AHI ?50. After adjustment for age, sex, smoking habits, BMI, waist circumference, cardiovascular morbidity, daytime sleepiness, depression, insomnia, sleep duration, and study site, odds ratios (95% CIs) for HbA^sub 1c^ >6.0% were 1 (reference), 1.40 (0.84-2.32), 1.80 (1.19-2.72), 2.02 (1.31-3.14), and 2.96 (1.58-5.54) for AHI values <5, 5 to <15, 15 to <30, 30 to <50, and ?50, respectively. Increasing hypoxemia during sleep was also independently associated with the odds of HbA^sub 1c^ >6.0%. Among adults without known diabetes, increasing OSA severity is independently associated with impaired glucose metabolism, as assessed by higher HbA^sub 1c^ values, which may expose them to higher risks of diabetes and cardiovascular disease.