Article record

1型糖尿病老年患者阻塞性睡眠呼吸暂停风险增加和睡眠质量差：DCCT/EDIC研究

Increased Risk of Obstructive Sleep Apnea and Poor Sleep Quality Among Older Adults With Type 1 Diabetes: The DCCT/EDIC Study.

临床研究咽喉科IF 16.7Q1

文献信息

PMID	42809017
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Catherine L Martin 查看其他 13 位作者 Matthew Bott；William H Herman；Barbara H Braffett；Victoria R Trapani；Ionut Bebu；Harsha Karanchi；Jean M Lawrence；Jennifer Sherr；Gayle M Lorenzi；Pearl G Lee；David M Nathan；Ronald D Chervin；Rose A Gubitosi-Klug
作者单位	Department of Internal Medicine, University of Michigan, Ann Arbor, MI. 查看其他 8 条单位信息 Biostatistics Center, George Washington University, Bethesda, MD.；College of Medicine, Medical University of South Carolina, Charleston, SC.；National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.；Yale School of Medicine, New Haven, CT.；University of California, San Diego, La Jolla, CA.；Massachusetts General Hospital, Harvard Medical School, Boston, MA.；Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI.；Case Western Reserve University School of Medicine, Cleveland, OH.
期刊	Diabetes care
SCI 分区	Q1
IF	16.7
研究类型	临床研究 · 临床
所属专科	咽喉科

中文摘要

目的： 探讨1型糖尿病老年患者睡眠问题的患病率及其危险因素。
研究设计与方法： 糖尿病控制与并发症试验/糖尿病干预与并发症流行病学（DCCT/EDIC）研究中的1型糖尿病参与者完成了经过验证的问卷，以评估睡眠相关问题，包括阻塞性睡眠呼吸暂停（OSA）风险（中/高风险：STOP-Bang ≥3）、睡眠质量差（匹兹堡睡眠质量指数 >5）以及轻度或更严重的日间过度嗜睡（Epworth嗜睡量表 >10）。采用逻辑回归模型评估人口学和临床变量、血糖以及糖尿病并发症与每种睡眠问题的比值比。
结果： 在963名1型糖尿病参与者（52%为男性，平均[标准差]年龄64[7]岁，平均[标准差]病程43[5]年）中，分别有29%和19%的参与者报告了确诊的OSA和当前使用气道正压装置。64%的参与者存在OSA风险增加，43%存在睡眠质量差，10%存在日间嗜睡。当前或平均HbA1c每绝对增加1%（11 mmol/mol），与任何睡眠问题的比值增加15%至20%相关。在调整年龄、性别、BMI和平均HbA1c的模型中，心血管自主神经病变与中/高OSA风险的较高比值比相关，而白蛋白尿和严重低血糖与睡眠质量差的较高比值比相关。
结论： OSA风险和睡眠质量差在DCCT/EDIC参与者中很常见。对长期1型糖尿病的老年个体进行睡眠评估以及研究以确定解释所观察到的关联的机制是必要的。

英文摘要

OBJECTIVE: To investigate the prevalence of sleep problems and their risk factors among older adults with type 1 diabetes.
RESEARCH DESIGN AND METHODS: Participants with type 1 diabetes in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study completed validated questionnaires to assess sleep-related problems, including risk of obstructive sleep apnea (OSA) (intermediate/high risk: STOP-Bang ≥3), poor sleep quality (Pittsburgh Sleep Quality Index >5), and mild or greater levels of excessive daytime sleepiness (Epworth Sleepiness Scale >10). Logistic regression models assessed the odds of each sleep problem by demographic and clinical variables, glycemia, and diabetes complications.
RESULTS: In 963 participants (52% male, mean [SD] age 64 [7] years) with type 1 diabetes (mean [SD] duration 43 [5] years), diagnosed OSA and current positive airway pressure device use were reported by 29% and 19% of participants, respectively. Increased OSA risk was present in 64%, poor sleep quality in 43%, and daytime sleepiness in 10% of participants. Each 1% absolute increase (11 mmol/mol) in current or mean HbA1c was associated with 15% to 20% higher odds of any sleep problem. In models adjusted for age, sex, BMI, and mean HbA1c, cardiovascular autonomic neuropathy was associated with higher odds of intermediate/high OSA risk, and albuminuria and severe hypoglycemia were associated with higher odds of poor sleep quality.
CONCLUSIONS: OSA risk and poor sleep quality were common among DCCT/EDIC participants. Sleep assessments for older individuals with long-standing type 1 diabetes and research to identify mechanisms to explain the observed associations are warranted.