Stratification of Obstructive Sleep Apnea Risk in Obese non-Diabetics and Obese Diabetics

Abstract

Introduction: The prevalence of OSA and its consequences are likely to increase in light of the current obesity epidemic. Studies have shown that the prevalence of OSA is significantly higher in the diabetes population. Recent studies have revealed that BMI and diabetes as significant independent predictors of OSA. Owing to little research in this field and lack of data from Central India, the present study aims at assessing the risk of development of obstructive sleep apnoea in obese and obese diabetic patients. Objectives: To find out the prevalence of OSA risk in obese patients with Diabetes mellitus using Berlin Questionnaire, to find out the prevalence of OSA risk in obese non diabetic patients, correlation of OSA risk with Body Mass Index, fasting blood sugar, HbA1c and Blood Pressure. Methodology: Twenty four obese diabetic patients (Group I) and thirty-five obese – non- diabetic patients (Group II) were selected from medicine OPD randomly. Results were matched with thirty-one healthy non-obese nondiabetic controls (Group III). Risk of OSA was assessed using pre designed, validated Berlin questionnaire. HbA1C and fasting blood sugars were done. Results: As per Berlin Questionnaire Category 1 showed 19 (79.17%), 21 (60%) and 7 (22.58%) cases as positive in ‘DM and Obese’, ‘No DM but Obese’ and ‘Control’ groups respectively, P-value<0.0001 using Chi-square test, Category 2 had 7 (29.17%), 6 (17.14%) and 0 cases as positive in ‘DM and Obese’, ‘No DM but Obese’ and Control groups respectively with P-value of 0.008 (P<0.05) using Chi-square test and Category 3 had 18 (75%), 25 (71.4%) and 1(3.23%) positive cases in ‘DM and Obese’, ‘No DM but Obese’ and ‘Control’ groups respectively, and the difference in the proportions was statistically significant with P-value<0.0001 using Chi-square test. Age above 40 years, female sex increased the risk of OSA. HbA1C was found out to be an independent risk factor for OSA risk. After adjusting for covariates for HbA1C, the OR obtained was 6.20 [95% CI: 1.37-28.07], with a P-value of 0.018 (P<0.05). Conclusion: Our study shows that the risk of OSA is significantly increases with increasing BMI, fasting blood glucose levels, mean arterial pressure and HbA1c levels. High risk of OSA was 58.9% in our study.