Cardiometabolic correlates of sleep disordered breathing in Andean highlanders

Arias, Rafael S.; Schwartz, Noah G.; Gilman, Robert Hugh; Miele, Catherine H.; Miranda, J. Jaime; Checkley, William; Pham, Luu V.; Polotsky, Vsevolod Y.; Rattner, Adi; Schwartz, Alan R.

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 Hugh
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.ispartofseries	European Respiratory Journal
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#3.02.07
dc.relation.issn	1399-3003