Endocrine Abstracts

JOINT2479

Background.: Obstructive sleep apnea (OSA) is a chronic sleep disorder characterized by repeated episodes of the upper airway obstruction during sleep, resulting in hypoxemia, hypercapnia, sleep fragmentation. Individuals with sleep apnea are often unaware of their breathing difficulties during sleep, leading to frequent underdiagnosis of the condition. If left untreated, OSA can lead to hypertension, cardiovascular diseases, neurocognitive impairments, and metabolic dysfunction. OSA is frequently associated with type 2 diabetes (T2D), with prevalence reaching up to 86%, particularly among obese diabetic patients. OSA increases cardiovascular risk and is associated with high oxidative stress levels and inflammation. Under conditions of increased oxidative stress, the accumulation of advanced glycation end-products (AGEs) is accelerated. Higher AGEs levels are associated with metabolic syndrome, cardiovascular disease, and diabetes-related complications. This study aimed to analyze the relationship between AGEs levels and the presence of OSA in patients with diabetes.

Materials and methods: AGEs concentration in the skin was non-invasively measured using AGE Reader in 117 patients with type 1 diabetes (T1D, n =61) and T2D (n =56), with low (n=39), intermediate (n =42) and high (n =36) risk of OSA. The STOP-BANG questionnaire, validated and adapted for Lithuanian patients, was used. High risk for OSA was defined by as any of the following: a total score of 5-8 points; positive responses to ≥2 of 4 questions plus male gender or plus BMI >35 kg/m² or plus neck circumference ≥40 cm. Intermediate risk was defined by 3-4, low risk by 0-2 positive answers. Data on patients’ clinical characteristics were collected from medical records.

Results: The median diabetes duration was 16 years (range1-60), age – 56 years (range 20-81). The study cohort consisted of 67 (57.3%) women and 50 (42.7%) men. The risk of developing OSA significantly depended on gender (P<0.001) and type of diabetes (P<0.001). Men and patients with T2D have higher risk of developing OSA compared with woman and patients with T1D. There were no significant associations between OSA and HbA1c or the duration of diabetes (P = 0.602 and P = 0.267, respectively). However, we revealed a progressive increase in AGE median values as OSA risk increases (P<0.05).

Conclusions: Patients with T2D, particularly males, demonstrate a higher risk of developing OSA. Our findings suggest that non-invasive measurement of skin AGEs could be useful additional tool for OSA risk evaluation as the association between higher AGEs levels and OSA risk shows the potential role of oxidative stress in the pathophysiology of both conditions.