Table 1.
Baseline characteristics of all studies included in the review
| Author (year) | Country | n | OSA cases/total | Non‐OSA cases/total | Mean age (years) | Mean BMI (kg/m2) | Male/female | Sleep assessment | DM assessment | DM criteria | Prediabetes/diabetes | Follow up (years) | NOS | Adjustment factors |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cohort studies n = 8 | ||||||||||||||
|
KIM 6 2013 |
Korea | 1,344 | 246/625 | 150/719 | 57.7 | 24.8 | 706/638 | PSG | OGTT | ADA | IFG, IGT, IGR, DM | 4 | 9 |
Age, sex, alcohol use, smoking exercise, HTN CVD, medication for dyslipidemia, WC, VFA |
|
Appleton 22 2015 |
Australia | 736 | 41/374 | 25/362 | 59.7 | 28.4 | 736/0 | PSG | FPG ≥7.0 mmol/L or HbA1c ≥6.5% or physician diagnosis or national Pharmaceutical Benefits Scheme data record | NR | T2DM | 4.7 | 8 | Age, ESS, body fat percentage, education, income, marital status, medication use, shift work, change in WC≥5 cm |
|
Kendzerska 23 2014 |
Canada | 8,678 | 836/6,719 | 166/1,959 |
CG 42.0 Mild 47.0 Mod 50.0 Severe51.0 |
25.8 27.8 28.8 31.1 |
5,377/3,301 | PSG | Ontario Diabetes Database (ODD) | ICD9‐CM250 | DM | 5.58 | 9 | Age, sex, BMI, WC, smoking, comorbidities, income |
| Liu 25 2017 | Taiwan | 100,914 | 653/9,174 | 4,203/91,740 | ≥18 | † | 64,834/36,080 | PSG | Inpatient diagnosis or at least three outpatient diagnoses within 1 year | ICD9‐CM250 | T2DM | 12 | 7 | Age, sex, metabolic factors |
| Naga 26 2016 | USA | 1,453 | 155/688 | 130/765 | 63 | 28.3 | 675/778 | Respiratory monitoring | Physician‐diagnosed diabetes or diabetes medication use | FPG ≥126 mg/dL or non‐FPG of ≥200 mg/dL | DM | 13 | 8 | Age, sex, education, income, occupation, marital status, smoking, alcohol use, exercise, BMI, WC |
|
Strausz 27 2018 FINRISK |
Finland | 28,953 | 250/1,214 | 2,231/27,739 | 48.01 | 26.74 | 13,792/15,161 | ICD codes | Hospital discharges, causes‐of‐deaths register or entitlement to a reimbursed diabetes medication | NR | T2DM | 22 | 9 | Age, sex, geographical area, cohort year, BMI |
|
Strausz 27 2018 H2000 |
Finland | 6,605 | 45/235 | 411/6,370 | 53.8 | 26.9 | 2,940/3,665 | ICD codes | Hospital discharges, causes‐of‐deaths register or entitlement to a reimbursed diabetes medication | NR | T2DM | 14.5 | 9 | Age, sex, geographical area, cohort year, BMI |
|
Xu 28 2019 |
Hong Kong | 1,206 | 136/893 | 16/313 | 51 | 26.9 | 832/374 | PSG | Physician diagnosis or glycemic indices | ADA | T2DM | 7.34 | 9 | Age, sex, BMI, bodyweight change, WC, smoking, alcohol use, family history of T2DM, ESS, comorbidities |
|
Lindberg 24 2012 |
Sweden | 141 | 16/71 | 7/70 | 57.5 | 26.9 | 141/0 | Respiratory monitoring | OGTT | WHO | DM | 11.3 | 8 | Age, BMI, hypertension |
| Author (year) | Country | n | OSA cases/total | Non‐OSA cases/total | Mean age (years) | Mean BMI (kg/m2) | Male/female | Sleep assessment | DM assessment | DM criteria | Prediabetes/diabetes | AHRQ | Adjustment factors |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cross sectional studies n = 14 | |||||||||||||
|
Bikov 29 2020 |
Hungary | 394 | 60/282 | 12/112 | 58 | 32.5 | 288/106 | PSG | Blood samples | NR | DM | 7 | Age, sex, BMI, ESS |
|
Bozkurt 30 2012 |
Turkey | 47 | 23/143 | 1/47 |
CG 42.79 ± 9.55 Mild 47.78 ± 10.35 MOD 49.79 ± 10.62 severe 49.66 ± 10.38 |
29.24 ± 9.55 29.03 ± 4.12 30.76 ± 5.09 33.41 ± 4.64 |
141/96 | PSG | OGTT | ADA | IGR, T2DM | 6 | Sex, AHI |
|
Bulcun 31 2012 |
Turkey | 131 | 16/112 | 0/19 |
CG 45.89 ± 9.6 OSA 48.0 ± 10.1 |
28.8 ± 4.1 30.9 ± 4.6 |
101/30 | PSG | OGTT | WHO |
IFG, IGT, T2DM |
6 | Age, sex, BMI, severity of OSA, arousal index, drowsiness |
|
EI 32 2016 |
Italy | 163 | 83/126 | 17/37 |
CG 41.3 OSA 48.2 |
40 45.4 |
NR | PSG | OGTT | NR | IGT | 5 | NR |
|
Feng 33 2015 |
China | 180 | 78/140 | 12/40 | 45.4 ± 10.5 | 27.5 ± 4.1 | 162/18 | PSG | OGTT | WHO | IGR, T2DM | 7 | Neck circumference |
|
Fredheim 34 2011 |
Norway | 137 | 71/84 | 27/53 | 43 | 46.9 | 36/101 | Portable monitors | OGTT | ADA | IGR, T2DM | 8 | Age, sex, BMI (WC, neck circumference, WHR), HOMA‐IR, hs‐CRP |
|
Gasa 35 2011 |
Spain | 159 | 52/115 | 14/44 | 43 ± 10 | 46.1 ± 5.8 | 44/115 | PSG | OGTT |
DM: PBG ≥11.1 mmol/L IGT: PBG 7.8–11.1 mmol/L |
IGT, T2DM | 8 | Age, sex, smoking, BMI, WC |
|
Gilardini 36 2013 |
Italy | 98 | 7/54 | 7/44 |
PM CG 37.5 ± 9.5 PM OSA 41.7 ± 8.0 M CG 58.5 ± 8.4 M OSA 62.9 ± 6.1 |
36.0 ± 3.4 39.5 ± 4.8 33.5 ± 3.3 36.8 ± 3.7 |
0/98 | PSG | OGTT | ADA | IFG, IGT | 6 |
Age, BMI, WHR, NHR, FM/FFM FPG, 2hPG, ISI |
|
Gu 37 2013 |
China | 179 | 59/120 | 15/59 |
CG 26.25 ± 10.98 mild to MOD35.17 ± 14.68 severe 40.56 ± 13.52 |
34.19 ± 5.65 31.92 ± 5.42 33.89 ± 6.55 |
138/41 | PSG | OGTT | WHO | IFG, IGT, DM | 8 | Age, sex, BMI, smoking, alcohol use |
|
GU 38 2016 |
China | 106 | 13/59 | 2/47 |
CG 23.1 ± 6.2 OSA 26.0 ± 7.1 |
36.0 ± 4.7 37.2 ± 5.3 |
74/32 | PSG | OGTT | WHO | T2DM | 7 | Age, sex, BMI, hypertension |
|
Hasan 39 2012 |
India | 290 | 138/234 | 13/56 |
CG 52 ± 8 OSA 54 ± 11 |
29 ± 4 36 ± 6 |
225/65 | PSG | medical questionnaire or physician | NR | DM | 7 | BMI, hypertension, smoking, alcohol use |
|
Li 40 2020 |
China | 422 | 107/257 | 40/165 | 27.77 ± 7.51 | 34.84 ± 5.69 | 261/161 | PSG | OGTT |
IFG: FPG ≥6.1 mmol/L and <7.0 mmol/L, and 2hPG v<7.8 mmol/L. IGT: FPG <6.1 mmol/L, and 2hPG ≥7.8 mmol/L and <11.1mmol/L. IGR: FPG ≥6.1 mmol/L and <7.0 mmol/L, and 2hPG ≥7.8 mmol/L and <11.1 mmol/L. |
IFG, IGT, IGR | 7 | Age, sex, BMI, neck circumference, smoking |
|
Michalek 41 2021 |
Poland | 102 | 18/85 | 4/17 | 53.02 ± 12.37 | 30.50 ± 6.29 | 71/31 | PSG | Blood samples | NR | IFG, IGT | 6 | Age, AHI, ODI, BMI |
|
Togeiro 42 2013 |
Brazil | 1042 | 173/396 | 139/646 |
CG 37.3 ± 12.3 Mild 48.3 ± 13.6 MOD 53.3 ± 13.3 |
25.3 ± 4.4 28.3 ± 5.2 30.3 ± 6.0 |
466/576 | PSG | Blood samples | DM: FPG ≥126 mg/dL, use of diabetes medications or a previous diagnosis of diabetes. IFG: glucose serum value was≥100 mg/dL | IFG, T2DM | 8 | Age, sex, abdominal obesity (WC ≥88 cm for women and ≥102 cm for men), total sleep time |
| Case–control studies n = 3 | |||||||||||||
|
Bozic 3 2016 |
Croatia | 76 | 24/56 | 3/20 |
CG 52.5 ± 9.0 MOD 54.1 ± 10.9 Severe51.2 ± 11.8 |
28.3 ± 3.1 28.8 ± 2.6 29.8 ± 3.1 |
76/0 | PSG | OGTT | ADA | IFG, IGT | 8 | Subjects in both groups have similar BMI and abdominal circumference. |
|
Papaioannou 43 2011 |
UK | 105 | 37/68 | 12/37 |
CG 45 OSA 49 |
28 30 |
NR | PSG | OGTT | ADA | IGT | 7 | Age, BMI, AHI |
|
Silva 44 2018 |
Brazil | 120 | 12/85 | 2/35 |
CG 36 ± 9 OSA 47 ± 9 |
24 ± 3 28 ± 4 |
59/61 | PSG | Blood samples | FPG ≥126 mg/dL, use of DM medications. | DM | 8 | Age, sex, BMI, WC |
Baseline characteristics of the included studies. †BMI not measured in the original text, obesity‐related cardiometabolic variables were used. 2hPG, 2‐h plasma glucose; ADA, American Diabetes Association; AHI, apnea hypopnea index; BMI, body mass index; CG, control group; CVD, cardiovascular disease; DM, diabetes; ESS, Epworth Sleepiness Scale; FM/FFM, fat mass/fat free mass ratio; FPG, fasting glucose; HbA1c, glycated hemoglobin; HOMA‐IR, homeostasis model assessment of insulin resistance; hs‐CRP, high sensitivity CRP; HTN, hypertension; ICD codes, International Classification of Diseases; IFG, impaired fasting glucose; IGR, impaired glucose regulation; IGT, impaired glucose tolerance; ISI, insulin sensitivity index; M, menopausal women; MOD, moderate; NHR, neck/height ratio; NOS, Newcastle–Ottawa Scale; NR, not reported; ODI, oxygen de‐saturation index; OGTT, oral glucose tolerance test; OSA, obstructive sleep apnea; PBG, post‐load glucose; PM, premenopausal women; PSG, polysomnography; T2DM, type 2 diabetes; VFA, visceral fat area; WC, waist circumference; WHO, World Health Organization; WHR, waist‐to‐hip ratio.