Association of sleep apnea hypopnea syndrome and diabetic kidney disease in elderly type 2 diabetes patients / 中国医师杂志

ABSTRACT

Objective:To analyze the association of sleep apnea hypopnea syndrome (SAHS) and diabetic kidney disease (DKD) in elderly type 2 diabetes (T2DM) patients and to explore possible mechanism.Methods:84 elderly hospitalized patients with T2DM and had underwent sleep breathing monitoring in Guangzhou First People's Hospital during March 2018 to January 2019 were collected.Those patients were divided into three groups according to their apnea-hypopnea indices (AHI) no or mild SAHS group, moderate group and severe group. The general clinical data, blood biochemical indexes, urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were collected and compared among the three groups. Multiple regression analysis was used to analyze the influencing factors of eGFR and lnUACR in elderly patients with type 2 diabetes.Results:The lowest SpO 2 and eGFR in moderate and severe SAHS group were lower than those in no or mild SAHS group, while the UACR, homocysteine (Hcy), serum amyloid (SAA), AHI, oxygen desaturation index (ODI), serum creatinine, Cystatin C and high sensitivity C-reactive protein (hsCRP) were higher in moderate and severe SAHS group than those in no or mild SAHS group ( P<0.05). The severity of SAHS was positively correlated with the stage of chronic kidney disease (CKD) and albuminuria level ( r=0.504, 0.382, P<0.05). Multiple linear regression model showed that lnAHI, hemoglobin A1c (HbA1c) and systolic blood pressure (SBP) were independently correlated with eGFR; lnAHI and SBP were independently correlated with lnUACR; ODI, gender and age were independently correlated with EGFR; ODI and SBP were independently correlated with lnUACR. Conclusions:SAHS is an independent risk factor for renal complications in elderly diabetic patients, and its mechanism may be related to oxidative stress and inflammatory reaction.