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The correlation between obstructive sleep apnea and diabetic neuropathy: A meta-analysis

  • Author Footnotes
    1 Co-first authors.
    Xiandong Gu
    Footnotes
    1 Co-first authors.
    Affiliations
    Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
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  • Author Footnotes
    1 Co-first authors.
    Xuming Luo
    Footnotes
    1 Co-first authors.
    Affiliations
    Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
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  • Xiongbiao Wang
    Affiliations
    Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
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  • Jihong Tang
    Affiliations
    Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
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  • Wei Yang
    Affiliations
    Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
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  • Zhuying Cai
    Correspondence
    Corresponding author at: Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, No. 164, LanXi Road, Shanghai 200062, China.
    Affiliations
    Department of Respiratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
    Search for articles by this author
  • Author Footnotes
    1 Co-first authors.

      Highlights

      • Obstructive sleep apnea was an independent risk factor for diabetic neuropathy.
      • Obstructive sleep apnea was significantly correlated with type I diabetic neuropathy.
      • Obstructive sleep apnea was not markedly correlated with type II diabetic neuropathy.

      Abstract

      Background

      The aim of this study was to explore the correlation between obstructive sleep apnea (OSA) and diabetic neuropathy.

      Materials and methods

      After working out searching strategy, literatures were screened from the electronic databases: PubMed, Embase, and the Cochrane library. R 3.12 was utilized to perform meta-analysis, and odds ratio (OR) and its 95% confidence interval (CI) were used to present effect size. Heterogeneity was assessed by χ2-based Q test and I2 statistics. Publication bias was estimated by Egger’s test and sensitivity was evaluated by leave one out methods.

      Results

      According to the criteria, a total of 11 studies with 1842 patients were enrolled in this study. With a significant heterogeneity (Q = 31.83, I2 = 68.60%), the random effects model was utilized to assess the effect size of pooled data. A remarkable correlation was identified OSA and diabetic neuropathy (OR = 1.84, 95% CI: 1.18–2.87) without publication bias (t = 1.68, P = 0.13). Meanwhile, the result of leave one out performed a well sensitivity. Moreover, the subgroup analyses presented that OSA was significantly correlated with type 1 diabetic neuropathy (OR = 1.97, 95% CI: 1.19–3.25), but no remarkable correlation was identified between OSA and type 1 (OR = 1.84, 95% CI: 0.86–3.93) or 1 + 2 (OR = 1.30, 95% CI: 0.43–3.92) diabetic neuropathy.

      Conclusion

      OSA was significantly correlated with neuropathy in type 1 diabetes, but not in type 2 and type 1 + 2 diabetes.

      Keywords

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