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Impact of sleep-disordered breathing on glucose metabolism among individuals with a family history of diabetes: the Nagahama study

Minami, Takuma 京都大学 DOI:10.14989/doctor.k23097

2021.03.23

概要

【研究の目的】糖尿病家族歴（family history of diabetes; FHD）はⅡ型糖尿病発症の危険因子として認められている。睡眠呼吸障害（sleep disordered breathing; SDB）がFHD を有する者の糖尿病有病率の増加に関連しているか否かについては明らかでない。

【方法】7,477 人の研究参加者において、携帯型加速度計で客観的睡眠時間を測定し、基準値に対して3%酸素飽和度の低下を有意として睡眠1 時間あたり、15 回以上の低下有を中等症以上のSDB、5 回未満をSDB 無とした。HbA1c ≥6.5%、または/もしくは糖尿病に対する投薬治療群を糖尿病有りと定義とした。調査時点の糖尿病の有病率に加えて、SDBを評価する以前の約5 年間の期間内の発症した糖尿病の有病率も調査した。

【結果】7,477 名の参加者（平均年齢 57.9 [範囲 34.2-80.7、標準偏差 12.1] 歳；女性が67.7%）において1,569 名がFHD を有していた。FHD 陽性者の糖尿病の有病率は、中等症以上の SDB 群でSDB 無群よりも有意に高値であった（中等症以上SDB 群 対 SDB 無群：参加者全体、29.3% 対 3.3%、P <0.001；女性、32.6% 対 1.9%, P <0.001；男性、26.2%対 11.7%、P = 0.037）。多変量解析では中等症以上のSDB はFHD 陽性の女性においてのみ糖尿病の有病率の上昇と有意に関連していた（オッズ比 [95%信頼区間]：女性、7.43 [3.16-17.45]; 男性、0.92 [0.37-2.31]）。FHD 陽性者において、調査前5 年間に発症した糖尿病の有病率は女性においてのみ、中等症以上 SDB 群で SDB 無群よりも有意に高値であった（中等症以上SDB 群 対 SDB 無群：21.4% 対 1.1%；P <0.001）。

【結論】中等症以上のSDBはFHD を有する女性における糖尿病有病率上昇と関連があり、 FHD を有する女性におけるSDB 治療が糖尿病の発症を予防するか否かの検討が今後必要である。

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