Relationship Between Hyperuricemia-Waist Phenotype and Obstructive Sleep Apnea in Type 2 Diabetes Mellitus

Figures & data

Table 1 Characteristics of Participants by Phenotypes of SUA Concentrations and WC

Variables	Total (n = 255)	Group A (n = 53)	Group B (n = 21)	Group C (n = 136)	Group D (n = 45)	P
Sex (male/female) [n (%)]	165 (64.7)/90 (35.3)	30 (56.6)/23 (43.4)	15 (71.4)/6 (28.6)	83 (61.0)/53 (39.0)	37 (82.2)/8 (17.8)^a,c	0.033
Age (year)	52.05 ± 12.37	52.89 ± 11.18	52.38 ± 12.36	53.18 ± 12.36	47.49 ± 13.07	0.056
Smoking [n (%)]	95 (37.3)	15 (28.3)	4 (19.0)	56 (41.2)	20 (44.4)	0.084
Drinking [n (%)]	88 (34.5)	12 (22.6)	7 (33.3)	46 (33.8)	23 (51.1)^a,c	0.032
Duration of diabetes (year)	4.00 (1.00–9.00)	4.00 (1.75–9.50)	5.00 (1.00–9.50)	4.00 (1.00–9.00)	2.50 (0.40–9.00)	0.686
HbA1c (%)	8.62 ± 1.94	8.42 ± 1.96	8.45 ± 2.20	8.71 ± 1.92	8.69 ± 1.93	0.792
UA (μmol/L)	365.85 ± 95.46	300.08 ± 55.80	470.03 ± 83.65^a	329.41 ± 48.36^a,b	504.78 ± 65.82^a,b,c	0.000
WC (cm)	94.33 ± 9.90	82.66 ± 4.80	85.41 ± 3.68	97.63 ± 7.31^a,b	102.27 ± 8.30^a,b,c	0.000
AHI	18.08 ± 15.56	6.41 ± 5.69	10.90 ± 8.41	19.88 ± 14.95^a,b	29.71 ± 17.46^a,b,c	0.000
LSaO2 (%)	81.68 ± 7.67	85.43 ± 5.21	84.24 ± 7.73	81.27 ± 7.24^a	77.31 ± 8.95^a,b,c	0.000
OSA [n (%)]	204 (80.0)	23 (43.4)	15 (71.4)^a	122 (89.7)^a,b	44 (97.8)^a,b	0.000
Moderate-to-severe OSA [n (%)]	120 (47.0)	4 (7.5)	6 (28.6)^a	77 (56.9)^a,b	33 (72.7)^a,b,c	0.000
Hypoxemia [n (%)]	225 (88.2)	37 (69.8)	17 (81.0)	128 (94.1)^a,b	43 (95.6)^a	0.000
Moderate and severe hypoxemia [n (%)]	162 (63.5)	24 (45.3)	8 (38.1)	92 (67.6)^a,b	38 (84.4)^a,b,c	0.000

Notes: Group A: normal WC and normal SUA concentrations; group B: normal WC and elevated SUA concentrations; group C: enlarged WC and normal SUA concentrations; group D: enlarged WC and elevated SUA concentrations. ^aCompared with group A, P < 0.05; ^bCompared with group B, P < 0.05; ^cCompared with group C, P < 0.05.

Abbreviations: AHI, Apnea-hypopnea index; HbA1c, glycosylated hemoglobin A1c; LSaO₂, lowest oxygen saturation; OSA, obstructive sleep apnea; UA, uric acid; WC, waist circumference.

Figure 1 Composition of different severities of OSA in different groups by phenotypes of serum UA levels and WC (n).

Notes: Group A: normal WC and normal serum UA levels; group B: normal WC and elevated SUA levels; group C: enlarged WC and normal SUA levels; group D: enlarged WC and elevated SUA levels. a: compared with group A, P < 0.05; b: compared with group B, P < 0.05; c: compared with group C, P < 0.05.

Figure 2 Composition of different severities of OSA in different groups by phenotypes of SUA levels and WC (%).

Notes: Group A: normal WC and normal SUA levels; group B: normal WC and elevated SUA levels; group C: enlarged WC and normal SUA levels; group D: enlarged WC and elevated SUA levels. a: compared with group A, P < 0.05; b: compared with group B, P < 0.05; c: compared with group C, P < 0.05.

Table 2 Adjusted ORs and 95% CIs for OSA (AHI ≥5) Risk According to Phenotypes of Serum UA Concentrations and WC

Variables	Cases/Controls	Cases (%)	Model 1		Model 2		Model 3
			OR (95% CI)	P	OR (95% CI)	P	OR (95% CI)	P
Group A	23/30	43.4	1.00		1.00		1.00
Group B	15/6	71.4	3.261 (1.095–9.713)	0.034	3.483 (1.126–10.776)	0.030	3.678 (1.150–11.760)	0.028
Group C	122/14	89.7	11.366 (5.235–24.677)	0.000	12.548 (5.602–28.104)	0.000	12.112 (5.342–27.463)	0.000
Group D	44/1	97.8	59.391 (7.350–448.133)	0.000	80.708 (9.863–660.446)	0.000	82.387 (9.873–687.495)	0.000

Notes: Group A: normal WC and normal SUA concentrations; group B: normal WC and elevated SUA concentrations; group C: enlarged WC and normal SUA concentrations; group D: enlarged WC and elevated SUA concentrations. Model 1 univariate logistic regression analysis. Model 2 adjusted for age and sex. Model 3 adjusted model 2 covariates plus duration of diabetes, HbA1c, smoking, and drinking.

Abbreviations: CI, confidence interval; OR, odds ratio; UA, uric acid; WC, waist circumference.

Table 3 Adjusted ORs and 95% CIs for Moderate-to-Severe OSA (AHI ≥15) Risk According to Phenotypes of Serum UA Concentrations and WC

Variables	Cases/Controls	Cases (%)	Model 1		Model 2		Model 3
			OR (95% CI)	P	OR (95% CI)	P	OR (95% CI)	P
Group A	4/49	7.5	1.00		1.00		1.00
Group B	6/15	28.6	4.900 (1.219–19.694)	0.025	5.057 (1.218–20.996)	0.026	4.744 (1.117–20.146)	0.035
Group C	77/59	56.9	15.987 (5.461–46.802)	0.000	18.428 (6.105–55.631)	0.000	21.286 (6.847–66.169)	0.000
Group D	33/12	72.7	33.687 (9.999–113.493)	0.000	50.359 (13.894–182.523)	0.000	55.110 (14.854–204.462)	0.000

Notes: Group A: normal WC and normal SUA concentrations; group B: normal WC and elevated SUA concentrations; group C: enlarged WC and normal SUA concentrations; group D: enlarged WC and elevated SUA concentrations. Model 1 univariate logistic regression analysis. Model 2 adjusted for age and sex. Model 3 adjusted model 2 covariates plus duration of diabetes, HbA1c, smoking, and drinking.

Abbreviations: CI, confidence interval; OR, odds ratio; UA, uric acid; WC, waist circumference.

Table 4 Multivariable Logistic Regression Analysis for OSA

Characteristics	OSA (AHI ≥5)			Moderate-to-Severe OSA (AHI ≥15)
	OR	95% CI	P value	OR	95% CI	P value
Sex (male/female)				0.513	0.269–0.976	0.042
Age (year)	1.040	1.009–1.073	0.012	1.055	1.028–1.082	0.000
UA (normal/elevated)	3.704	1.391–9.864	0.009	2.241	1.078–4.660	0.031
WC (normal/enlarged)	14.225	6.666–30.355	0.000	14.890	6.561–33.793	0.000

Note: Independent variables: sex, age, smoking, drinking, duration of diabetes, HbA1c, UA, and WC.

Abbreviations: CI, confidence interval; HbA1c, glycosylated hemoglobin A1c; OR, odds ratio; UA, uric acid; WC, waist circumference.

Data Sharing Statement

The datasets used and analyzed in this study are available from Fuzai Yin, the corresponding author, on reasonable request.