Effects Of Obstructive Sleep Apnea Hypopnea Syndrome On Type 2 Diabetic Retinopathy

Objective:To study the effect of obstructive sleep apnea hypopnea syndrome（OSAHS）on retinopathy of type 2 diabetes mellitus（T2DM）and to study the risk factors of diabetic retinopathy（DR）.Methods:Patients with T2DM who received polysomnography（PSG）in Handan Central Hospital from October 2018 to July 2020 were selected to diagnose whether they had OSAHS.Reference into and exclusion criteria,for all the selected patients with retinal fundus examination,whether diagnosis of DR,record the patient’s general information and biochemical indicators,including age,sex,smoking history,drinking history and glycosylated hemoglobin,cereal third transaminase,aspertate aminotransferase index.A total of 228 patients who met the diagnostic criteria for T2DM were enrolled.According to PSG monitoring results,they were grouped based on the prevalence of OSAHS,namely,grouped according to the apnea hypopnea index（AHI）.Form the results,the sick person were divided into three groups,including 42patients in mild OSAHS group,101 patients in moderate and severe OSAHS group.The matched group（DM group）included 85 patients without OSAHS,namely T2DM patients alone.The differences in general information,biochemical indexes and sleep monitoring indexes were compared between the groups.SPSS24.0 software was used for analysis of all data.Results:1.Differences in general information among groups:The weight and BMI of the moderate and severe OSAHS group were higher than those in DM group and mild OSAHS group.The systolic pressure and waistline of the moderate and severe OSAHS group was higher than that of DM group.The 2h PBG,LDL,TC,UA in moderate and severe OSAHS group were higher than those in DM group.FINS,24U-ALB,FCP,HOMA-IR in moderate and severe OSAHS group were higher than those in DM group.2.The differences of sleep apnea monitoring indexes and prevalence of DR between each group:Comparison of sleep monitoring indexes in each group:AHI,ODI,SIT90:moderate and severe OSAHS group>mild OSAHS group>DM group;MSa O₂and LSa O₂:moderate and severe OSAHS group<mild OSAHS group<DM group.The prevalence of DR in each group:moderate and severe OSAHS group>mild OSAHS group>DM group.There were statistically significant differences in the above research results among the three groups（P<0.05）.3.Multivariate Logistic regression analysis of DR risk factors:The LDL,AHI,duration of diabetes were independent risk factors for DR.Spearman correlation analysis:DR was positively correlated with diabetes duration,LDL and AHI.Conclusion:1.BMI and waistline of T2DM patients with OSAHS were higher than those of T2DM patients alone.2.With the increase of the severity of OSAHS,the prevalence of DR in T2DM patients increased.3.The duration of diabetes,LDL and AHI are independent risk factors for the prevalence of DR.With the increase of diabetes duration,LDL and AHI,the risk of DR also increased.