Independent Association Between Obstructive Sleep Apnea Severity and Glycated Hemoglobin in AdultsWithout Diabetes

OBJECTIVEdWe tested the hypothesis of an independent cross-sectional association be-tween obstructive sleep apnea (OSA) severity and glycated hemoglobin (HbA1c) in adults with-out known diabetes. RESEARCH DESIGNANDMETHODSdHbA1c was measured in whole-blood samples from 2,139 patients undergoing nocturnal recording for suspected OSA. Participants with self-reported diabetes, use of diabetes medication, or HbA1c value $6.5 % were excluded from this study. Our final sample size comprised 1,599 patients. RESULTSdA dose-response relationship was observed between apnea-hypopnea index (AHI) and the percentage of patients with HbA1c.6.0%, ranging from 10.8 % for AHI,5 to 34.2 % for AHI $50. After adjustment for age, sex, smoking habits, BMI, waist circumference, cardiovas-cular morbidity, daytime sleepiness, depression, insomnia, sleep duration, and study site, odds ratios (95 % CIs) for HbA1c.6.0 % were 1 (reference), 1.40 (0.84–2.32), 1.80 (1.19–2.72), 2.02 (1.31–3.14), and 2.96 (1.58–5.54) for AHI values,5, 5 to,15, 15 to,30, 30 to,50, and $50, respectively. Increasing hypoxemia during sleep was also independently associated with the odds of HbA1c.6.0%