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Obstructive sleep apnoea and the risk for coronary heart disease and type 2 diabetes : A longitudinal population-based study in Finland

Strausz, Satu; Havulinna, Aki S.; Tuomi, Tiinamaija LU ; Bachour, Adel; Groop, Leif LU ; Mäkitie, Antti; Koskinen, Seppo; Salomaa, Veikko; Palotie, Aarno LU and Ripatti, Samuli LU , et al. (2018) In BMJ Open 8(10).
Abstract

Objective To evaluate if obstructive sleep apnoea (OSA) modifies the risk of coronary heart disease, type 2 diabetes (T2D) and diabetic complications in a gender-specific fashion. Design and setting A longitudinal population-based study with up to 25-year follow-up data on 36 963 individuals (>500 000 person years) from three population-based cohorts: the FINRISK study, the Health 2000 Cohort Study and the Botnia Study. Main outcome measures Incident coronary heart disease, diabetic kidney disease, T2D and all-cause mortality from the Finnish National Hospital Discharge Register and the Finnish National Causes-of-Death Register. Results After adjustments for age, sex, region, high-density lipoprotein (HDL) and total cholesterol,... (More)

Objective To evaluate if obstructive sleep apnoea (OSA) modifies the risk of coronary heart disease, type 2 diabetes (T2D) and diabetic complications in a gender-specific fashion. Design and setting A longitudinal population-based study with up to 25-year follow-up data on 36 963 individuals (>500 000 person years) from three population-based cohorts: the FINRISK study, the Health 2000 Cohort Study and the Botnia Study. Main outcome measures Incident coronary heart disease, diabetic kidney disease, T2D and all-cause mortality from the Finnish National Hospital Discharge Register and the Finnish National Causes-of-Death Register. Results After adjustments for age, sex, region, high-density lipoprotein (HDL) and total cholesterol, current cigarette smoking, body mass index, hypertension, T2D baseline and family history of stroke or myocardial infarction, OSA increased the risk for coronary heart disease (HR=1.36, p=0.0014, 95% CI 1.12 to 1.64), particularly in women (HR=2.01, 95% CI 1.31 to 3.07, p=0.0012). T2D clustered with OSA independently of obesity (HR=1.48, 95% CI 1.26 to 1.73, p=9.11× 10 7). The risk of diabetic kidney disease increased 1.75-fold in patients with OSA (95% CI 1.13 to 2.71, p=0.013). OSA increased the risk for coronary heart disease similarly among patients with T2D and in general population (HR=1.36). All-cause mortality was increased by OSA in diabetic individuals (HR=1.35, 95% CI 1.06 to 1.71, p=0.016). Conclusion OSA is an independent risk factor for coronary heart disease, T2D and diabetic kidney disease. This effect is more pronounced even in women, who until now have received less attention in diagnosis and treatment of OSA than men.

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published
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keywords
coronary heart disease, diabetic kidney disease, longitudinal, mortality, obstructive sleep apnea, type 2 diabetes
in
BMJ Open
volume
8
issue
10
publisher
British Medical Journal Publishing Group
external identifiers
  • scopus:85055072431
ISSN
2044-6055
DOI
10.1136/bmjopen-2018-022752
language
English
LU publication?
yes
id
9f8e3d59-64dd-4d59-8379-f7913373c203
date added to LUP
2018-11-16 09:59:00
date last changed
2019-05-21 04:15:04
@article{9f8e3d59-64dd-4d59-8379-f7913373c203,
  abstract     = {<p>Objective To evaluate if obstructive sleep apnoea (OSA) modifies the risk of coronary heart disease, type 2 diabetes (T2D) and diabetic complications in a gender-specific fashion. Design and setting A longitudinal population-based study with up to 25-year follow-up data on 36 963 individuals (&gt;500 000 person years) from three population-based cohorts: the FINRISK study, the Health 2000 Cohort Study and the Botnia Study. Main outcome measures Incident coronary heart disease, diabetic kidney disease, T2D and all-cause mortality from the Finnish National Hospital Discharge Register and the Finnish National Causes-of-Death Register. Results After adjustments for age, sex, region, high-density lipoprotein (HDL) and total cholesterol, current cigarette smoking, body mass index, hypertension, T2D baseline and family history of stroke or myocardial infarction, OSA increased the risk for coronary heart disease (HR=1.36, p=0.0014, 95% CI 1.12 to 1.64), particularly in women (HR=2.01, 95% CI 1.31 to 3.07, p=0.0012). T2D clustered with OSA independently of obesity (HR=1.48, 95% CI 1.26 to 1.73, p=9.11× 10 7). The risk of diabetic kidney disease increased 1.75-fold in patients with OSA (95% CI 1.13 to 2.71, p=0.013). OSA increased the risk for coronary heart disease similarly among patients with T2D and in general population (HR=1.36). All-cause mortality was increased by OSA in diabetic individuals (HR=1.35, 95% CI 1.06 to 1.71, p=0.016). Conclusion OSA is an independent risk factor for coronary heart disease, T2D and diabetic kidney disease. This effect is more pronounced even in women, who until now have received less attention in diagnosis and treatment of OSA than men.</p>},
  articleno    = {022752},
  author       = {Strausz, Satu and Havulinna, Aki S. and Tuomi, Tiinamaija and Bachour, Adel and Groop, Leif and Mäkitie, Antti and Koskinen, Seppo and Salomaa, Veikko and Palotie, Aarno and Ripatti, Samuli and Palotie, Tuula},
  issn         = {2044-6055},
  keyword      = {coronary heart disease,diabetic kidney disease,longitudinal,mortality,obstructive sleep apnea,type 2 diabetes},
  language     = {eng},
  number       = {10},
  publisher    = {British Medical Journal Publishing Group},
  series       = {BMJ Open},
  title        = {Obstructive sleep apnoea and the risk for coronary heart disease and type 2 diabetes : A longitudinal population-based study in Finland},
  url          = {http://dx.doi.org/10.1136/bmjopen-2018-022752},
  volume       = {8},
  year         = {2018},
}