DOI: https://doi.org/10.22141/2224-0721.15.2.2019.166095

The role of obstructive sleep apnea in atherosclerotic damage to the carotid arteries in type 2 diabetes mellitus

I.P. Doroshkevich, T.V. Mokhort

Abstract


Background. Obstructive sleep apnea syndrome is а common sleep disorders. There is now sufficient evidence of the negative impact of obstructive sleep apnea syndrome on the development of chronic complications of type 2 diabetes mellitus (DM). We investigated blood lipids and atherosclerotic changes in the carotid arteries in patients with type 2 DM depending on the presence of obstructive sleep apnea syndrome. Materials and methods. All participants with type 2 DM underwent polysomnography and ultrasound examination of the carotid arteries as well as the levels of glycated haemoglobin, high­density lipoprotein cholesterol, low­density lipoprotein cholesterol, total cholesterol, triglycerides and anthropometric parameters were assessed. The participants were divided into 3 groups: group 1 included patients with type 2 DM without obstructive sleep apnea syndrome, group 2 consisted of patients with type 2 DM and obstructive sleep apnea syndrome, group 3 involved patients with obstructive sleep apnea syndrome without type 2 DM. Results. Seventy­three percent patients with type 2 DM (28 % patients with moderate obstructive sleep apnea syndrome and 42 % — severe obstructive sleep apnea syndrome) experienced obstructive sleep apnea syndrome. The patients with obstructive sleep apnea syndrome were found to have reduced sleep efficiency, sleep duration, extension of hypnagogic state after falling asleep. The increased sleep apnea/hypopnea index is associated with an ele­vated total cholesterol, low­density lipoprotein, triglycerides in patients with type 2 DM and obstructive sleep apnea syndrome. In groups with obstructive sleep apnea syndrome, the carotid artery intima­media thickness correlates with increased apnea/hypopnea index and the reduction in blood oxygen saturation; the increased carotid artery intima­media thickness was associated with snoring in 100 % of cases. Conclusions. Obstructive sleep apnea syndrome in patients with type 2 DM and overweight in combination with nocturnal hypoxemia and snoring is associated with the development of carotid atherosclerosis.


Keywords


diabetes mellitus; sleep apnea; atherosclerosis; apnea/hypopnea index

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