Obstructive sleep apnea and risk of type 2 diabetes mellitus: A systematic review and dose-response meta-analysis of cohort studies.

Background: This meta-analysis was performed to quantitatively evaluate the dose-response association between obstructive sleep apnea (OSA) and risk of type 2 diabetes mellitus (T2DM).
Methods: PubMed, Embase, and Web of Science were searched up to 12 December 2018 for articles that assessed the OSA-T2DM association. Random effects models were used to analyze the quantitative association between OSA and risk of T2DM. Restricted cubic splines were used to model the dose-response association between apnea-hypopnea index (AHI), used to assess the severity of OSA according to events/h, and risk of T2DM.
Results: We included 16 cohort studies in our meta-analysis. During a median follow-up of 10.5 years (range: 3.0-22.0), 19 355 T2DM cases were reported among 338 912 study participants. The pooled relative risk of T2DM was 1.40 (95% CI, 1.32-1.48) for OSA in the binary meta-analysis and 1.08 (1.01-1.14) for each 5-event/h increase in AHI value. We found a positive linear association between OSA and T2DM risk.
Conclusions: Our dose-response meta-analysis revealed a linear association between OSA and T2DM.
(© 2019 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)