Abstract
Introduction: Sleep apnea and diabetes mellitus (DM) negatively impact cardiovascular health. One important indicator of cardiovascular health is the Ankle-Brachial Index (ABI). Either low (LABI) or high (HABI) are signs of peripheral vascular impairment. Impaired vascular health and DM, together, might provoke sleep apnea; however, information regarding these relationships is limited. Therefore, this study aimed to investigate the association between ABI, DM status, and severity of sleep apnea in people of Hispanic/Latino descent.
Methods: A cross sectional analysis from a multi-center epidemiologic study, HCHS/SOL, was utilized, including 8,378 participants (mean age 45.92?±?13.96, female = 49%, mean BMI=30.06?±?5.55). The sample was divided into 6 groups based on ADA guidelines (no-DM or DM) and ABI categories (LABI, normal ABI, or HABI). A linear regression was used to determine the strength of association between groups to predict the severity of sleep apnea, measured by the Apnea-Hypopnea Index (AHI). A Kruskal-Wallis H test was used for AHI comparisons between groups. Significance level was set at 0.01.
Results: There were significant differences between groups for mean AHI (P<0.001; no-DM+normal ABI= 19.28±16.57, DM+normal ABI = 26.85?±?21.87, no-DM+LABI = 17.63?±?18.22, DM?+LABI = 26.31?±?21.62, no-DM?+HABI = 27.12?±?19.82, and DM?+HABI = 33.0?±?22.01). Linear regression ?showed that DM and HABI was significantly associated with severe sleep apnea (β= 5.7, p=0.007) after controlling for age, waist-hip ratio, and Statin medication.
Conclusion: ?These data suggest that ?people with DM and HABI were more likely to have severe apnea compared to the other groups. People with DM, HABI, and severe sleep apnea might be at higher risk of cardiovascular complications. Thus, further research is required to elucidate the appropriate intervention to combat the high level of Peripheral artery disease.
Disclosure
M.M. Alshehri: None. A.S. Alqahtani: None. A.M. Alenazi: None. S. Alothman: None. M. Aldhahi: None. C.M. Gray: None. B. Alqahtani: None. P. Kluding: None.