The cumulative impact of type 2 diabetes and obstructive sleep apnoea on cardiovascular, liver, diabetes‐related and cancer outcomes
Authors' conclusion
T2D significantly potentiates risk of cardiovascular, malignancy and liver-related outcomes in individuals with OSA. OSA, in individuals with T2D, significantly potentiates risk of cardiovascular disease, malignancy, death and several microvascular complications (retinopathy, CKD, peripheral/autonomic neuropathy).
Study context
- Population
- Patients with obstructive sleep apnoea (OSA) and/or T2D in TriNetX global federated research network (n = 128 million)two matched analyses
- Exposure
- Analysis 1: OSA with T2D vs OSA alone; analysis 2: T2D with OSA vs T2D alone
- Outcome
- Cardiovascular, liver, diabetes-related (microvascular) and cancer events
- Follow-up
- 1-5 years
Methodological detailstwo retrospective cohort studies, propensity score matched (1:1), time-to-event analysis, global federated research network (TriNetX)
- Two retrospective cohort studies
- Propensity score matched (1:1)
- Time-to-event analysis
- Global federated research network (TriNetX)
Main finding
As reported in the abstract
Analysis 1 (n = 179 688): OSA + T2D vs OSA alone · 1-5 years after OSA diagnosis
OSA + T2D vs OSA aloneHazard ratio (CI)
All-cause mortality
1.52(1.48–1.57)
Dementia
1.19(1.12–1.26)
Liver cancer
2.20(1.77–2.73)
Pancreatic cancer
1.62(1.35–1.93)
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| Analysis 2 (n = 240 094): T2D + OSA vs T2D aloneT2D + OSAvs T2D alonePeripheral neuropathy · propensity score matched | 1.39 (1.36–1.43) | |
| Analysis 2 (n = 240 094): T2D + OSA vs T2D aloneT2D + OSAvs T2D aloneAutonomic neuropathy · propensity score matched | 1.63 (1.51–1.75) | |
| Analysis 2 (n = 240 094): T2D + OSA vs T2D aloneT2D + OSAvs T2D aloneRetinopathy · propensity score matched | 1.13 (1.09–1.18) | |
| Analysis 2 (n = 240 094): T2D + OSA vs T2D aloneT2D + OSAvs T2D aloneCKD · propensity score matched | 1.21 (1.18–1.23) | |
| 0.512Hazard ratio (log scale) |
Analysis 2 (n = 240 094): T2D + OSA vs T2D alone
- Significantly increased risk of all cardiovascular and liver outcomes, all-cause mortality and several obesity related cancers vs T2D alone
Original publication
The cumulative impact of type 2 diabetes and obstructive sleep apnoea on cardiovascular, liver, diabetes‐related and cancer outcomes. Diabetes Obes Metab. Published 11 November 2024. doi:10.
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