Sleep Disordered Breathing and Impaired Glucose Metabolism in Normal Weight and Overweight/Obese Individuals: The Sleep Heart Health Study

Abstract

Objective: To characterize the association between sleep-disordered breathing (SDB) and impaired fasting glucose (IFG), impaired glucose tolerance (IGT), combined IFG + IGT, and occult diabetes mellitus (DM) in individuals of different body habitus.

Research Design and Methods: Cross-sectional analysis of 2,588 participants (age 52-96 years; 46% men) without known DM. SDB was defined as respiratory disturbance index ≥ 10 events/hour. IFG, IGT, occult DM, and body weight were classified according to recent accepted guidelines. Participants with and without SDB were compared on prevalence and odds ratios for measures of impaired glucose metabolism (IGM), adjusting for age, gender, race, BMI and waist circumference.

Results: SDB was observed in 209 non-overweight and 1036 overweight/obese participants. SDB groups had significantly higher adjusted prevalence and adjusted odds of IFG, IFG + IGT, and occult DM. The adjusted odds ratio for all subjects was 1.3 (1.1, 1.6) for IFG, 1.2 (1.0, 1.4) for IGT, 1.4 (1.1, 2.7) for IFG + IGT, and 1.7 (1.1, 2.7) for occult DM.

Conclusion: SDB was associated with occult DM, IFG, and IFG + IGT after adjusting for age, gender, race, BMI and waist circumference. The magnitude of these associations was similar in non-overweight and overweight participants. The consistency of associations across all measures of IGM and body habitus groups, and the significant association between SDB and IFG + IGT, a risk factor for rapid progression to diabetes, cardiovascular disease, and mortality, suggests the importance of SDB as a risk factor for clinically important levels of metabolic dysfunction.