The influence of diabetes on sleep-derived cardiorespiratory features of the finger pulse wave signal – The population-based SCAPIS study

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY Sleep medicine Pub Date : 2024-08-17 DOI:10.1016/j.sleep.2024.08.016

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Abstract

Study objectives

Advanced signal processing of photoplethysmographic data enables novel analyses which may improve the understanding of the pathogenesis of dysglycemia associated with sleep disorders. We aimed to identify sleep-related pulse wave characteristics in diabetic patients compared to normoglycemic individuals, independent of cardiovascular-related comorbidities.

Methods

This cross-sectional evaluation of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) included overnight oximetry-derived pulse wave data from 3997 subjects (45 % males, age 50–64 years). Metabolic status was classified as normoglycemic (n = 3220), pre-diabetic (n = 544), or diabetic (n = 233). Nine validated pulse wave features proposed to influence cardiovascular risk were derived and compared between metabolic status groups. Logistic prediction models and genetic matching were applied to capture diabetes-related pulse wave characteristics during sleep. The model was controlled for anthropometrics, lifestyle, sleep apnea, and in the final adjustment even for cardiometabolic factors like dyslipidaemia, hypertension, and coronary artery calcification.

Results

Pulse wave-derived parameters differed between normoglycemic and diabetic individuals in eight dimensions in unadjusted as well as in the partially adjusted model (anthropometric factors and sleep apnea, p ≤ 0.001). All covariates confirmed significant differences between normoglycemic and diabetic subjects (all p ≤ 0.001). Reduced cardio-respiratory coupling (respiratory-related pulse oscillations) (β = −0.010, p = 0.012), as well as increased vascular stiffness (shortened pulse propagation time (β = −0.015, p = 0.001), were independently associated with diabetes even when controlled for cardiometabolic factors. These results were confirmed through a matched cohort comparative analysis.

Conclusions

Photoplethysmographic pulse wave analysis during sleep can be utilized to capture multiple features of modified autonomic regulation and cardiovascular consequences in diabetic subjects. Dampened heart rate variability and increased vascular stiffness during sleep showed the strongest associations with diabetes.

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糖尿病对手指脉搏波信号的睡眠心肺功能特征的影响--基于人群的 SCAPIS 研究

研究目的先进的信号处理技术可对光敏血压数据进行新颖的分析，从而提高人们对与睡眠障碍相关的血糖异常发病机制的认识。我们旨在确定糖尿病患者与血糖正常者相比与睡眠相关的脉搏波特征，这些特征与心血管相关的合并症无关。方法这项以人群为基础的瑞典CArdio-Pulmonary bioImage研究（SCAPIS）的横断面评估包括来自3997名受试者（45%为男性，年龄在50-64岁之间）的隔夜血氧饱和度衍生脉搏波数据。代谢状态分为血糖正常（3220 人）、糖尿病前期（544 人）或糖尿病（233 人）。研究人员得出了九种经过验证的脉搏波特征，这些特征被认为会影响心血管风险，并在代谢状况组之间进行了比较。应用逻辑预测模型和基因匹配来捕捉睡眠期间与糖尿病相关的脉搏波特征。结果在未经调整和部分调整的模型（人体测量因素和睡眠呼吸暂停，p ≤ 0.001）中，血糖正常者和糖尿病患者的脉搏波衍生参数在八个方面存在差异。所有协变量均证实，血糖正常者与糖尿病患者之间存在显著差异（所有 p 均小于 0.001）。即使控制了心脏代谢因素，心肺耦合（呼吸相关脉搏振荡）降低（β = -0.010，p = 0.012）和血管僵硬度增加（脉搏传播时间缩短（β = -0.015，p = 0.001））也与糖尿病独立相关。结论睡眠时的光电脉搏波分析可用于捕捉糖尿病受试者自主神经调节改变和心血管后果的多种特征。睡眠时心率变异性减弱和血管僵硬度增加与糖尿病的关系最为密切。

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.