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Vascular dysfunction in obstructive sleep apnea and type 2 diabetes mellitus
Susie Yim-Yeh1, Shilpa Rahangdale, Anh Tu Duy Nguyen
1Brigham and Women's Hospital, Boston, Massachusetts, USA.
Obesity (Silver Spring, Md.)
|June 5, 2010
Summary
Obstructive sleep apnea (OSA) impairs vascular function similarly to type 2 diabetes, affecting brachial artery dilation. Treating OSA may improve macrovascular outcomes in diabetic patients.
Area of Science:
- Cardiovascular Science
- Endocrinology
- Sleep Medicine
Background:
- Obstructive sleep apnea (OSA) is common in type 2 diabetes mellitus (DM).
- The specific vascular risks attributable to OSA and DM individually are not well understood.
- This study investigates whether OSA contributes to vascular dysfunction similarly to type 2 diabetes.
Purpose of the Study:
- To compare the effects of OSA and type 2 diabetes on vascular function.
- To determine if OSA independently impacts vascular endothelial function.
- To explore potential therapeutic implications for managing vascular risk in patients with both conditions.
Main Methods:
- Vascular function assessed using brachial artery flow-mediated dilation (FMD) and skin microcirculation laser Doppler flowmetry.
- Study included healthy normal-weight controls, healthy obese controls, type 2 diabetes patients, and obese patients with OSA.
- Statistical analysis included multiple linear regression to identify predictors of FMD.
Main Results:
- Both OSA and type 2 diabetes groups exhibited significantly impaired FMD compared to control groups.
- Multiple regression analysis revealed OSA and type 2 diabetes status as independent negative predictors of % FMD.
- OSA did not significantly affect endothelium-independent vasodilation or skin microcirculatory function.
Conclusions:
- Obstructive sleep apnea impairs endothelial function in the brachial artery to a degree comparable to type 2 diabetes.
- OSA does not appear to affect endothelium-independent vasodilation or skin microvascular function.
- Treating OSA in patients with type 2 diabetes may offer a strategy to improve macrovascular, but not microvascular, outcomes.
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