| Abstract | Uvod: Brojne studije ukazale su na povezanosti među inzulinskom rezistencijom, dijabetesom tipa 2 i opstrukcijskom apnejom tijekom spavanja (engl. Obstructive Sleep Apnea, OSA). Inzulinska rezistencija i dijabetes tipa 2 su čimbenici rizika za razvoj OSA-e, dok je OSA jedan od čimbenika rizika za razvoj dijabetesa tipa 2. Cilj ovog istraživanja jest procijeniti rizik za razvoj opstrukcijske apneje tijekom spavanja i ispitati kvalitetu života u bolesnika s dijabetesom tipa 2.
Metode: Proveli smo presječno istraživanje koje je uključivalo ukupno 466 pacijenata (223 muškarca i 243 žene) s dijabetesom tipa 2 (prosječna starost 66,3±10,7 godina) u Regionalnom centru za dijabetes, endokrinologiju i bolesti metabolizma Kliničkog bolničkog centra Split. Pacijenti su ispunili 3 upitnika. STOP upitnik (engl. Snoring, Tiredness, Observed and Pressure) korišten je za procjenu rizika za razvoj OSA-e, dok je prekomjerna dnevna pospanost procijenjena Epworthovom ljestvicom pospanosti (engl. Epworth Sleepiness Scale, ESS). Također, svi ispitanici su ispunili upitnik SF-36 (engl. Short Form-36) koji mjeri kvalitetu života povezanu sa zdravljem prema osam domena.
Rezultati: Statistička analiza pokazala je da 312 (67%) ispitanika ima povećani rizik za razvoj OSA-e (STOP zbir ≥2). Ovi ispitanici su imali i veći indeks tjelesne mase (ITM) (29,6±5,1 naprema 27,02±4,35 kg/m2; P<0,001), veći opseg vrata (38,2±5,0 naprema 37,07±3,7 cm; P=0,003), veći opseg struka (103,7±13,8 naprema 98,1±12,1 cm; P<0,001) te su imali veći ESS zbir (6,5±4,5 naprema 3,99±3,27; P<0,001) u usporedbi s pacijentima bez rizika za razvoj OSA-e. Vrijednosti glikiranog hemoglobina (HbA1c) u pacijenata s povećanim rizikom za razvoj OSA-e su bile 8,0±1,81%, dok su u pacijenata bez rizika za razvoj OSA-e ove vrijednosti iznosile 7,7±1,79% (P=0,074). Pacijenti s povećanim rizikom za razvoj OSA-e su imali značajno niži zbir u SF-36 upitniku (P<0,001 za svaku od 8 domena). Ukupni STOP zbir pokazao je negativnu korelaciju sa svakom domenom SF-36 upitnika (P<0,001).
Zaključak: Naše istraživanje pokazalo je da velik broj pacijenata s dijabetesom tipa 2 ima povećan rizik za razvoj OSA-e i da ovi pacijenti imaju značajno lošiju kvalitetu života povezanu sa zdravljem. |
| Abstract (english) | Introduction: Numerous studies suggest a relationship among insulin resistance, diabetes type 2 and obstructive sleep apnea (OSA). Insulin resistance and diabetes type 2 are risk factors for developing OSA, while OSA is one of the risk factors for developing type 2 diabetes. The goal of this study was to assess overall health-related quality of life among enrolled patients and to identify patients with a high risk for developing OSA with reference to preexisting diabetes type 2 diagnosis.
Methods: We conducted a cross-sectional study which enrolled a total of 466 patients (223 men and 243 women) with type 2 diabetes (mean age 66.3±10.7 years) at the Regional Centre for Diabetes, Endocrinology and Metabolic Diseases of University Hospital Split. Patients were enrolled consecutively during regular examination at the Center and were offered 3 questionnaires. STOP questionnaire (Snoring, Tiredness, Observed and Pressure) was used in the evaluation of the risk for OSA, while excessive daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). Additionally, all participants completed widely used Short Form-36 (SF-36) questionnaire which measures health-related quality of life across eight physically and emotionally based domains.
Results: Statistical analysis showed that 312 (67%) participants had increased risk for OSA (STOP score ≥2), and they had higher body mass index (BMI) (29.6±5.1 vs. 27.02±4.35 kg/m2, P<0.001), higher neck circumference (38.2±5.0 vs. 37.07±3.7 cm, P=0.003), higher waste circumference (103.7±13.8 vs. 98.1±12.1 cm, P<0.001) and had higher ESS score (6.5±4.5 vs. 3.99±3.27, P<0.001) compared to the patients without risk for OSA. In addition, HbA1c values in patients with increased risk for OSA were 8.0±1.81 %, while in patients without risk for OSA they were 7.7±1.79 % (P=0.074). Patients with increased risk for OSA had significantly lower SF-36 scores (P<0.001 for each of 8 domains). Moreover, overall STOP score showed negative correlation with every domain of the SF-36 survey (P<0.001).
Conclusion: Our study showed that high percentage of patients with type 2 diabetes have increased risk for development of OSA, and those patients have significantly decreased health-related quality of life. |
