The Association between Obstructive Sleep Apnea on Diabetic Kidney Disease: A Systematic Review and Meta-Analysis

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The Association between Obstructive Sleep Apnea on Diabetic Kidney Disease : A Systematic Review and Meta-Analysis. / Leong, Wen Bun; Jadhakhan, Ferozkhan; Taheri, Shahrad; Thomas, G Neil; Adab, Peymané.

In: Sleep, Vol. 39, No. 2, 31.08.2015.

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@article{2d80972fc28d4438bf891d204415cba3,
title = "The Association between Obstructive Sleep Apnea on Diabetic Kidney Disease: A Systematic Review and Meta-Analysis",
abstract = "STUDY OBJECTIVE: This systematic review aims to summarise the association between obstructive sleep apnea (OSA) and diabetic kidney disease (DKD).DESIGN: MeSH terms and free text searches were performed on MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception to April 2015. Zetoc and OpenGrey databases were queried for grey literature, and lastly, hand searches were carried out. Study selection and quality assessment were conducted by two authors. One author carried out data extraction, which was checked by other authors. The relationships between apnea-hypopnea index (AHI), oxygen desaturation index (ODI), time spent under 90% oxygen saturation (%TST<90), and minimum and mean oxygen saturation (O2) on DKD were examined.MEASUREMENT AND RESULTS: Two longitudinal and ten cross-sectional studies were included for our narrative synthesis, and seven studies for meta-analysis. Studies that performed multi-variable analysis demonstrated significant associations between OSA (assessed using either apnea-hypopnea index or ODI) and DKD in type 2 diabetes mellitus (T2DM). This was confirmed by meta-analysis (pooled OR 1.73, 95% CI: 1.13-2.64). There was some evidence to suggest that %TST<90 may have an association with DKD. There was insufficient evidence to conclude on the relationship between minimum and mean oxygen saturation on DKD. There was no evidence available on the associations between OSA and other respiratory parameters in type 1 diabetes mellitus populations.CONCLUSION: There is moderate evidence that OSA is associated with DKD in patients with T2DM. Large prospective studies with long-term follow up are needed to assess the possible bi-directional mechanisms between OSA and DKD.",
author = "Leong, {Wen Bun} and Ferozkhan Jadhakhan and Shahrad Taheri and Thomas, {G Neil} and Peyman{\'e} Adab",
note = "Copyright {\textcopyright} 2015 Associated Professional Sleep Societies, LLC. All rights reserved.",
year = "2015",
month = aug,
day = "31",
doi = "10.5665/sleep.5432",
language = "English",
volume = "39",
journal = "Sleep",
issn = "0161-8105",
publisher = "American Academy of Sleep Medicine",
number = "2",

}

RIS

TY - JOUR

T1 - The Association between Obstructive Sleep Apnea on Diabetic Kidney Disease

T2 - A Systematic Review and Meta-Analysis

AU - Leong, Wen Bun

AU - Jadhakhan, Ferozkhan

AU - Taheri, Shahrad

AU - Thomas, G Neil

AU - Adab, Peymané

N1 - Copyright © 2015 Associated Professional Sleep Societies, LLC. All rights reserved.

PY - 2015/8/31

Y1 - 2015/8/31

N2 - STUDY OBJECTIVE: This systematic review aims to summarise the association between obstructive sleep apnea (OSA) and diabetic kidney disease (DKD).DESIGN: MeSH terms and free text searches were performed on MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception to April 2015. Zetoc and OpenGrey databases were queried for grey literature, and lastly, hand searches were carried out. Study selection and quality assessment were conducted by two authors. One author carried out data extraction, which was checked by other authors. The relationships between apnea-hypopnea index (AHI), oxygen desaturation index (ODI), time spent under 90% oxygen saturation (%TST<90), and minimum and mean oxygen saturation (O2) on DKD were examined.MEASUREMENT AND RESULTS: Two longitudinal and ten cross-sectional studies were included for our narrative synthesis, and seven studies for meta-analysis. Studies that performed multi-variable analysis demonstrated significant associations between OSA (assessed using either apnea-hypopnea index or ODI) and DKD in type 2 diabetes mellitus (T2DM). This was confirmed by meta-analysis (pooled OR 1.73, 95% CI: 1.13-2.64). There was some evidence to suggest that %TST<90 may have an association with DKD. There was insufficient evidence to conclude on the relationship between minimum and mean oxygen saturation on DKD. There was no evidence available on the associations between OSA and other respiratory parameters in type 1 diabetes mellitus populations.CONCLUSION: There is moderate evidence that OSA is associated with DKD in patients with T2DM. Large prospective studies with long-term follow up are needed to assess the possible bi-directional mechanisms between OSA and DKD.

AB - STUDY OBJECTIVE: This systematic review aims to summarise the association between obstructive sleep apnea (OSA) and diabetic kidney disease (DKD).DESIGN: MeSH terms and free text searches were performed on MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception to April 2015. Zetoc and OpenGrey databases were queried for grey literature, and lastly, hand searches were carried out. Study selection and quality assessment were conducted by two authors. One author carried out data extraction, which was checked by other authors. The relationships between apnea-hypopnea index (AHI), oxygen desaturation index (ODI), time spent under 90% oxygen saturation (%TST<90), and minimum and mean oxygen saturation (O2) on DKD were examined.MEASUREMENT AND RESULTS: Two longitudinal and ten cross-sectional studies were included for our narrative synthesis, and seven studies for meta-analysis. Studies that performed multi-variable analysis demonstrated significant associations between OSA (assessed using either apnea-hypopnea index or ODI) and DKD in type 2 diabetes mellitus (T2DM). This was confirmed by meta-analysis (pooled OR 1.73, 95% CI: 1.13-2.64). There was some evidence to suggest that %TST<90 may have an association with DKD. There was insufficient evidence to conclude on the relationship between minimum and mean oxygen saturation on DKD. There was no evidence available on the associations between OSA and other respiratory parameters in type 1 diabetes mellitus populations.CONCLUSION: There is moderate evidence that OSA is associated with DKD in patients with T2DM. Large prospective studies with long-term follow up are needed to assess the possible bi-directional mechanisms between OSA and DKD.

UR - http://www.ncbi.nlm.nih.gov/pubmed/26414891

U2 - 10.5665/sleep.5432

DO - 10.5665/sleep.5432

M3 - Article

C2 - 26414891

VL - 39

JO - Sleep

JF - Sleep

SN - 0161-8105

IS - 2

ER -