Relationship between obstructive sleep apnea hypopnea syndrome and the occurrence and progression of type 2 diabetic nephropathy

Objective To explore the correlation between obstructive sleep apnea hypopnea syndrome(OSAHS) and diabetic nephropathy(DN) in type 2 diabetes mellitus(T2DM) patients.Methods A total of 92 T2DM patients with DN during June 1-May 30,2020 were selected while 75 T2DM patients without DN during the same period designated as controls.All patients were tested for serum cystatin C,γ-aminobutyric acid(γ-GABA) and urine albumin excretion(UAE) on the basis of routine diagnosis and treatment.Polysomnograph was utilized for 8-hour continuous recording and apnea-hypopnea index(AHI),minimum night blood oxygen saturation(LSaO₂) and night average blood oxygen saturation(MSaO₂) were recorded.Results No inter-group statistical differences existed in age,gender composition,body mass index(BMI),fasting blood glucose,hypertension or hypercholesterolemia.The average diabetic duration was prolonged in DN patients,the incidence of OSAHS spiked.The levels of HbA1c,CysC and AHI rose while the levels of LSaO₂,MSaO₂ and γ-GABA declined(all P<0.05).They were divided into three groups of normal albuminuria,micro-albuminuria and massive albuminuria according to the level of UAE.The disease courses of DN and AHI became elongated markedly while LSaO₂,MSaO₂ and γ-GABA declined markedly(all P<0.05).Further multivariate Logistic regression analysis indicated that AHI was an independent risk factor for an onset of DN(P=0.044) while LSaO₂,MSaO₂ and γ-GABA were independent protective factors for DN in T2DM patients(all P<0.01).Conclusion OSAHS is correlated with DN occurrence so that alleviating OSAHS may delay the progression of DN.