title: The Relationship between Diabetic Neuropathy and Sleep Apnea Syndrome: A Meta-Analysis.
abstract: Aims. High prevalence of sleep apnea syndrome (SAS) has been reported in patients with diabetes. However, whether diabetic neuropathy (DN) contributes to this high prevalence is controversial. Our aim of this study is to compare the prevalence of SAS between patients with and without DN. Methods. Systematic literature searches were conducted for cross-sectional studies that reported the number of patients with DN and SAS using MEDLINE (from 1966 to Nov 5, 2012) and EMBASE (from 1974 to Nov 5, 2012). Odds ratios (ORs) of SAS related to DN were pooled with the Mantel-Haenszel method. Results. Data were obtained from 5 eligible studies (including 6 data sets, 880 participants, and 429 cases). Overall, the pooled OR of SAS in patients with DN compared with that in non-DN patients was significant (OR (95% CI), -1.95 (1.03-3.70)). The pooled OR of SAS was 1.90 (0.97-3.71) in patients with type 2 diabetes. Excluding data on patients with type 1 diabetes, a higher OR was observed in younger patients (mean age <60 years) than in those ≥60 years among whom the OR remained significant (3.82; 95% CI, 2.24-6.51 and 1.17; 95% CI, 0.81-1.68). Conclusions. Current meta-analysis suggested the association of some elements of neuropathy with SAS in type 2 diabetes. Further investigations are needed to clarify whether the association is also true for patients with type 1 diabetes.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Tsukuba University, Japan ; Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata, Niigata 951-8510, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Fujihara
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Tsukuba University, Japan ; Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata, Niigata 951-8510, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Kodama
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Tsukuba University, Japan ; Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata, Niigata 951-8510, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Horikawa
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Tsukuba University, Japan ; Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata, Niigata 951-8510, Japan.
authors.forename: Sakiko
authors.initials: S
authors.lastname: Yoshizawa
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Tsukuba University, Japan ; Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata, Niigata 951-8510, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Sugawara
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Tsukuba University, Japan ; Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata, Niigata 951-8510, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Hirasawa
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Tsukuba University, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shimano
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata, Niigata 951-8510, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yachi
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata, Niigata 951-8510, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata, Niigata 951-8510, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Hanyu
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Niigata University, 1-754 Asahimachi, Niigata, Niigata 951-8510, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sone