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Cardiometabolic correlates of sleep disordered breathing in Andean highlanders

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dc.contributor.author Pham, Luu V.
dc.contributor.author Miele, Catherine H.
dc.contributor.author Schwartz, Noah G.
dc.contributor.author Arias, Rafael S.
dc.contributor.author Rattner, Adi
dc.contributor.author Gilman, Robert H.
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Polotsky, Vsevolod Y.
dc.contributor.author Checkley, William
dc.contributor.author Schwartz, Alan R.
dc.date.accessioned 2019-01-25T15:02:19Z
dc.date.available 2019-01-25T15:02:19Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4615
dc.description.abstract Associations between sleep disordered breathing (SDB) and cardiometabolic outcomes have not been examined in highlanders.We performed nocturnal polygraphy in Peruvian highlanders (3825 m). Multivariable linear regression models examined associations between SDB metrics and haemoglobin, glucose tolerance (haemoglobin A1c (HbA1c)), fasting glucose, homeostatic model-based assessments of insulin resistance and beta-cell function (HOMA-IR and HOMA-beta, respectively), blood pressure, and lipids, while adjusting for age, sex, body mass index (BMI) and wake oxygenation.Participants (n=187; 91 men) were (median (interquartile range)) 52 (45-62) years old, and had a BMI of 27.0 (24.3-29.5) kg.m(-2) and 87% (85-88%) oxyhaemoglobin (arterial oxygen) saturation during wakefulness. In fully adjusted models, worsening nocturnal hypoxaemia was associated with haemoglobin elevations in men (p=0.03), independent of wake oxygenation and apnoea-hypopnoea index (AHI), whereas worsening wake oxygenation was associated with haemoglobin elevations in older women (p=0.02). In contrast, AHI was independently associated with HbA1c elevations (p<0.05). In single-variable models, nocturnal hypoxaemia was associated with higher HbA1c, HOMA-IR and HOMA-beta (p<0.001, p=0.02 and p=0.04, respectively), whereas AHI was associated with HOMA-IR, systolic blood pressure and triglyceride elevations (p=0.02, p=0.01 and p<0.01, respectively). These associations were not significant in fully adjusted models.In highlanders, nocturnal hypoxaemia and sleep apnoea were associated with distinct cardiometabolic outcomes, conferring differential risk for excessive erythrocytosis and glucose intolerance, respectively. en_US
dc.language.iso eng
dc.publisher European Respiratory Society
dc.relation.ispartof urn:issn:1399-3003
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Aged en_US
dc.subject Middle Aged en_US
dc.subject Risk Factors en_US
dc.subject Environment en_US
dc.subject Body Mass Index en_US
dc.subject Altitude en_US
dc.subject Glucose Intolerance/diagnosis/epidemiology en_US
dc.subject Oximetry/methods/statistics & numerical data en_US
dc.subject Polycythemia/diagnosis/epidemiology en_US
dc.subject Sleep Apnea Syndromes/diagnosis/epidemiology/metabolism/physiopathology en_US
dc.subject Blood Pressure Determination/statistics & numerical data en_US
dc.subject Glycated Hemoglobin A/analysis en_US
dc.subject Insulin Resistance/physiology en_US
dc.subject Lipids/analysis en_US
dc.subject Peru/epidemiology en_US
dc.subject Polysomnography/methods en_US
dc.title Cardiometabolic correlates of sleep disordered breathing in Andean highlanders en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1183/13993003.01705-2016
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.07

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