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The prevalence of retinopathy in men with Type 2 diabetes and obstructive sleep apnoea
Author(s) -
West S. D.,
Groves D. C.,
Lipinski H. J.,
Nicoll D. J.,
Mason R. H.,
Scanlon P. H.,
Stradling J. R.
Publication year - 2010
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2010.02962.x
Subject(s) - medicine , retinopathy , type 2 diabetes , sleep (system call) , diabetes mellitus , diabetic retinopathy , pediatrics , endocrinology , computer science , operating system
Diabet. Med. 27, 423–430 (2010) Abstract Aims To clarify the relationship between obstructive sleep apnoea (OSA) and diabetic retinopathy. Research design and methods A cohort of 240 men from primary and secondary care previously participated in a study on the prevalence of OSA in Type 2 diabetes and provided anthropometric information, details of their diabetes, had glycated haemoglobin (HbA 1c ) measured and overnight oximetry performed. They were re‐contacted for permission to review their routine screening clinical retinal photographs, which were then scored by a trained grader, providing detailed retinopathy, maculopathy and photocoagulation scores. Results One hundred and eighteen men both consented and had retinal photographs available to review. Of these, 24% had OSA, with mean ± sd 4% oxygen saturation (SaO 2 ) dips/h of 20.9 ± 16.6 vs. 2.8 ± 2.1 in the non‐OSA group. As expected, the OSA group had a significantly higher mean body mass index of 31.9 ± 5.2 vs. 28.5 ± 5.1 kg/m 2 and neck size 44.5 ± 3.6 vs. 41.9 ± 2.5 cm, but the two groups did not differ significantly in age, diabetes duration, diabetes treatment, HbA 1c , smoking history or proportion with known hypertension. Retinopathy and maculopathy scores were significantly worse in the OSA group ( P < 0.0001). Multiple regression analysis showed only OSA ( R 2 = 0.19, P < 0.0001) and HbA 1c ( R 2 = 0.04, P = 0.03) to be significant independent predictors of retinopathy. OSA was the only independent significant predictor of the total microaneurysm score ( R 2 = 0.21, P = 0.004), a detailed retinopathy subclassification. OSA was the only independent significant predictor of maculopathy ( R 2 = 0.3, P < 0.001). Conclusion In men with Type 2 diabetes, there is a strong association between retinopathy and OSA, independent of conventional retinopathy risk factors.