Cited by 1,107Obstructive Sleep Apnea ResearchSleep and related disordersDiabetes, Cardiovascular Risks, and Lipoproteins

Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study

Punjabi, N. M.·2004·American Journal of Epidemiology

Abstract

Clinic-based studies suggest that sleep-disordered breathing (SDB) is associated with glucose intolerance and insulin resistance. However, in the available studies, researchers have not rigorously controlled for confounding variables to assess the independent relation between SDB and impaired glucose metabolism. The objective of this study was to determine whether SDB was associated with glucose intolerance and insulin resistance among community-dwelling subjects (n=2,656) participating in the Sleep Heart Health Study (1994-1999). SDB was characterized with the respiratory disturbance index and measurements of oxygen saturation during sleep. Fasting and 2-hour glucose levels measured during an oral glucose tolerance test were used to assess glycemic status. Relative to subjects with a respiratory disturbance index of less than 5.0 events/hour (the reference category), subjects with mild SDB (5.0-14.9 events/hour) and moderate to severe SDB (> or =15 events/hour) had adjusted odds ratios of 1.27 (95% confidence interval: 0.98, 1.64) and 1.46 (95% confidence interval: 1.09, 1.97), respectively, for fasting glucose intolerance (p for trend < 0.01). Sleep-related hypoxemia was also associated with glucose intolerance independently of age, gender, body mass index, and waist circumference. The results of this study suggest that SDB is independently associated with glucose intolerance and insulin resistance and may lead to type 2 diabetes mellitus.

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Crossref · 10.1093/aje/kwh261

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Authors
Punjabi, N. M.
Affiliations
Johns Hopkins University (US)
Corresponding author
Punjabi, N. M.
Venue
American Journal of Epidemiology
Published
2004-09-15
Volume
160
Issue
6
Pages
521-530
ISSN
0002-9262 (ISSN-L)
OpenAlex
W2105727933
Cited by
1,107
References
65
Citations by year
2026: 19 · 2025: 26 · 2024: 31 · 2023: 35 · 2022: 32 · 2021: 37 · 2020: 39 · 2019: 43 · 2018: 68 · 2017: 47 · 2016: 71 · 2015: 65 · 2014: 61 · 2013: 74 · 2012: 77
FWCI
25.49
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Health and Human Services
  • National Institutes of Health (5u01hl053940-05, 5u01hl053934-14)
  • National Heart, Lung, and Blood Institute (U01 HL 53940, U01HL053941, R01HL075078, UO1HL63463, U01HL053938, UO1HL53937, U01HL053937, UO1HL53934, U01 HL 53941, U01HL053931, U01HL053916, UO1HL63429, UO1HL53938, HL075078, U01HL063463, UO1-HL53916, UO1HL53931, U01HL063429)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
sleep-disordered breathing, impaired glucose tolerance, insulin resistance, sleep-related hypoxemia, respiratory disturbance index, type 2 diabetes, impaired glucose metabolism, community-dwelling adults, Sleep Heart Health Study
MeSH terms
Aged, Blood Gas Analysis, Body Constitution, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Fasting, Female, Glucose Tolerance Test, Humans, Insulin Resistance, Male, Middle Aged, Oxyhemoglobins, Research Design, Risk Factors, Severity of Illness Index, Sleep Apnea Syndromes, Cohort Studies, Confounding Factors, Epidemiologic, Body Mass Index, Multivariate Analysis, Linear Models, Polysomnography, Glucose Intolerance

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