• Gonzalo Labarca, Jorge Dreyse, Constanza Salas, Alexia Schmidt, Francisca Rivera, Francisca Letelier, and Jorge Jorquera.
• Facultad de Medicina, Universidad de Concepcion, Barrio Universitario S/N, Concepcion, Chile. glabarcat@gmail.com.
• Sleep Breath. 2021 Sep 1; 25 (3): 1467-1475.

IntroductionPatients with obstructive sleep apnea (OSA) and comorbid diabetes mellitus (DM) are reported to have an increased risk of cardiovascular (CV) outcomes; however, data on CV mortality are scant.AimThis study aimed to evaluate if patients with comorbid OSA and DM have an increased risk of CV mortality that is higher than the two diseases in isolation.MethodsIn this prospective cohort study, we included patients referred for a sleep study with and without DM at baseline. We developed four study groups as follows: group 1 (reference group), OSA (-) DM (-); group 2, OSA (-) DM (+); group 3, OSA (+) DM (-); group 4, OSA (+) DM (+). Intergroup differences were evaluated using the t test and χ2 test, and multivariate analysis was performed using logistic regression. The incidence rates of CV mortality were calculated using the Kaplan-Meier (log-rank) model, and adjusted HRs were calculated using the Cox regression model.ResultsA total of 1447 patients were included in the analysis-group 1: 441 participants; group 2: 141 participants; group 3: 736 participants; group 4: 151 participants. The mean follow-up was 5 years. The association between OSA + DM showed an independent risk of incident CV mortality (HR 2.37, CI 1.16-4.82, p = 0.02) and an increased prevalence of coronary heart disease (OR 3.44, CI 1.73-5.59, p < 0.01). In addition, T90% was also associated with CV mortality.ConclusionThe coexistence of OSA + DM was associated with an independent risk of CV mortality. In addition, T90% was also associated with CV mortality.© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG part of Springer Nature.

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