Obstructive sleep apnea, prediabetes and progression of type 2 diabetes: A systematic review and meta‐analysis

• Published in: Journal of diabetes investigation Vol. 13; no. 8; pp. 1396 - 1411
• Main Authors: Wang, Cong, Tan, Jin, Miao, Yuyang, Zhang, Qiang
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.08.2022; John Wiley and Sons Inc; Wiley
• Subjects: Apnea; Bias; Cohort analysis; Cross-Sectional Studies; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Fasting; Female; Glucose; Glucose Intolerance - complications; Glucose Intolerance - epidemiology; Glucose tolerance; Humans; Laboratory testing; Male; Meta-analysis; Obstructive sleep apnea; Original; Prediabetes; Prediabetic State - complications; Prediabetic State - epidemiology; Questionnaires; Respiration; Risk factors; Self report; Sleep; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - epidemiology; Sleep disorders; Systematic review; Womens health; Prediabetes; Obstructive sleep apnea; Diabetes
• DOI: 10.1111/jdi.13793
• ISSN: 2040-1116; 2040-1124

Aims/Introduction Obstructive sleep apnea (OSA) is related to prediabetes and diabetes. Whether patients with OSA have a higher risk of prediabetes/diabetes remains unclear. We aimed to carry out a meta‐analysis of published studies to evaluate the relationships between OSA and prediabetes and diabetes, and the impact of the severity of OSA on diabetes. Materials and Methods The PubMed, EMBASE and Cochrane databases were searched from January 2011 to July 2021. The associations between OSA and impaired fasting glucose, impaired glucose tolerance, impaired glucose regulation and diabetes mellitus were analyzed. We estimated the pooled odds ratios using fixed or random effects models. We included 25 studies comprising a total of 154,948 patients with OSA and risk factors for prediabetes/diabetes (20 and 16, respectively) in the analysis. Results OSA was associated with a higher risk of impaired fasting glucose, impaired glucose tolerance, impaired glucose regulation and diabetes mellitus in the cohort studies and cross‐sectional studies. The pooled odds ratios were 2.34 (95% confidence interval [CI] 1.16–4.72), 1.58 (95% CI 1.15–2.15), 1.65 (95% CI 1.12–2.42), 2.15 (95% CI 1.68–2.75) and 3.62 (95% CI 2.75–4.75), respectively. Subgroup analyses were based on the proportions of men and women. The results showed that OSA was a risk factor, and there was no significant difference between the two groups. The risk of diabetes increased with the severity of OSA. Conclusions The risk of developing prediabetes and diabetes was higher in patients with OSA. Our study provides further evidence that obstructive sleep apnea is closely correlated with prediabetes and diabetes risk; the prevalence of prediabetes/diabetes in patients with obstructive sleep apnea was higher than that of patients without obstructive sleep apnea.