Relationship between diabetic retinopathy and sleep-disordered breathing.
OBJECTIVE
To clarify the relationships of sleep-disordered breathing (SDB) to nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).


METHODS
Cross sectional case-control study.


METHODS
Forty-eight consecutive NPDR and 118 PDR cases that had undergone surgery in our hospital were included in this study. Pulse oximetry was conducted during the night and the sleeping 4% oxygen desaturation index (ODI) (number of oxygen desaturation events/hour exceeding 4%) and mean SpO(2)% were calculated. If 4% ODI > 5 times/hour, SDB was diagnosed. The results were evaluated and compared between the 2 groups. In addition, these results and preoperative patient background factors were analyzed using multiple regression analysis to identify correlations with the diagnosis of PDR.


RESULTS
Twenty-nine percent of the NPDR and 48% of the PDR patients were diagnosed as having SDB. The incidence of SDB and the 4% ODI/hour value were significantly higher in the PDR than in the NPDR group (P = .003 and .03, respectively). Multiple regression analysis showed younger age and a higher 4% ODI value to be factors independently contributing to a diagnosis of PDR (age, standard regression coefficient = -0.34; t value = -4.44; P < .0001; 4% ODI, standard regression coefficient = 0.20; t value = 2.15; P = .03, correlation coefficient (R) = 0.43).


CONCLUSIONS
Our results suggest that, in diabetic retinopathy patients with nocturnal desaturation, reoxygenation caused by SDB may relate to the development of PDR.
Shiba
Tomoaki
T
Department of Ophthalmology, Toho University Sakura Medical Center, Sakura, Chiba, Japan. tomoaki-s@sakura.med.toho-u.ac.jp
Sato
Yukihiro
Y
Takahashi
Mao
M
D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000032:analysis; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010100:Oxygen / Q000378:metabolism; D010101:Oxygen Consumption / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*
D006442:Glycated Hemoglobin; D010100:Oxygen