Obstructive sleep apnea, coronary calcification and arterial stiffness in patients with diabetic kidney disease.

Autor: Nielsen S; Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark. Electronic address: Sebane@rm.dk., Nyvad J; Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark., Christensen KL; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark., Poulsen PL; Steno Diabetes Center, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Faculty of Heath, Aarhus University, Aarhus, Denmark., Laugesen E; Steno Diabetes Center, Aarhus University Hospital, Denmark; Diagnostic Center, Silkeborg Regional Hospital, Silkeborg, Denmark., Grove EL; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Heath, Aarhus University, Aarhus, Denmark., Buus NH; Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Heath, Aarhus University, Aarhus, Denmark.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2024 Jul; Vol. 394, pp. 117170. Date of Electronic Publication: 2023 Jun 29.
DOI: 10.1016/j.atherosclerosis.2023.06.076
Abstrakt: Background and Aims: Obstructive sleep apnea (OSA) may accelerate arterial calcification, but the relation remains unexplored in diabetic kidney disease (DKD). We examined the associations between OSA, coronary calcification and large artery stiffness in patients with DKD and reduced renal function.
Methods: Patients with type 2 diabetes, estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m 2 and urine albumin-creatinine ratio (UACR) > 30 mg/g were tested for OSA quantified by the apnea-hypopnea index (AHI, events/hour). Patients without OSA (AHI< 5) were compared to patients with moderate (AHI 15-29) or severe (AHI ≥30) OSA and underwent computed tomography angiography with coronary Agatston scoring (CAS) to quantify coronary calcification. Arterial stiffness was determined as carotid-femoral pulse wave velocity (PWV).
Results: Among 114 patients with acceptable AHI recordings had 43 no OSA, 33 mild OSA and 38 moderate-severe OSA. Mean age of the 74 patients completing the study was 71.5 ± 9.4 years (73% males), eGFR 32.2 ± 12.3 ml/min/1.73 m 2 and UACR 533 (192-1707) mg/g. CAS (ln-transformed) was significantly higher in patients with OSA compared to patients without (6.6 ± 1.7 vs. 5.6 ± 2.4, p = 0.04), and the same was observed for PWV (11.9 ± 2.7 vs. 10.5 ± 2.2 m/s, p = 0.02). In multivariable linear regression analyses adjusted for sex, age, body mass index, UACR, and mean arterial pressure, moderate-severe OSA remained significantly associated with PWV but not with CAS. Dominance analysis revealed OSA as the third and second most important factor relative to CAS and PWV respectively.
Conclusions: In DKD patients, moderate-severe OSA is a significant predictor of arterial stiffness but is not independently associated with coronary calcification.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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