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Nakatsuka Y, Murase K, Sonomura K, Tabara Y, Nagasaki T, Hamada S, Matsumoto T, Minami T, Kanai O, Takeyama H, Sunadome H, Takahashi N, Nakamoto I, Tanizawa K, Handa T, Sato TA, Komenami N, Wakamura T, Morita S, Takeuchi O, Nakayama T, Hirai T, Kamatani Y, Matsuda F, Chin K. Hyperfructosemia in sleep disordered breathing: metabolome analysis of Nagahama study. Sci Rep 2023; 13:12735. [PMID: 37543666 PMCID: PMC10404271 DOI: 10.1038/s41598-023-40002-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/03/2023] [Indexed: 08/07/2023] Open
Abstract
Sleep disordered breathing (SDB), mainly obstructive sleep apnea (OSA), constitutes a major health problem due to the large number of patients. Intermittent hypoxia caused by SDB induces alterations in metabolic function. Nevertheless, metabolites characteristic for SDB are largely unknown. In this study, we performed gas chromatography-mass spectrometry-based targeted metabolome analysis using data from The Nagahama Study (n = 6373). SDB-related metabolites were defined based on their variable importance score in orthogonal partial least squares discriminant analysis and fold changes in normalized peak-intensity levels between moderate-severe SDB patients and participants without SDB. We identified 20 metabolites as SDB-related, and interestingly, these metabolites were frequently included in pathways related to fructose. Multivariate analysis revealed that moderate-severe SDB was a significant factor for increased plasma fructose levels (β = 0.210, P = 0.006, generalized linear model) even after the adjustment of confounding factors. We further investigated changes in plasma fructose levels after continuous positive airway pressure (CPAP) treatment using samples from patients with OSA (n = 60) diagnosed by polysomnography at Kyoto University Hospital, and found that patients with marked hypoxemia exhibited prominent hyperfructosemia and their plasma fructose levels lowered after CPAP treatment. These data suggest that hyperfructosemia is the abnormality characteristic to SDB, which can be reduced by CPAP treatment.
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Affiliation(s)
- Yoshinari Nakatsuka
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuhiro Sonomura
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Tadao Nagasaki
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Hamada
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Matsumoto
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Respiratory Medicine, Saiseikai Noe Hospital, Osaka, Japan
| | - Takuma Minami
- Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Osamu Kanai
- Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Hirofumi Takeyama
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hironobu Sunadome
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naomi Takahashi
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Isuzu Nakamoto
- Nursing Science, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kiminobu Tanizawa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohiro Handa
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Taka-Aki Sato
- Life Science Research Center, Technology Research Laboratory, Shimadzu Corporation, Kyoto, Japan
| | - Naoko Komenami
- Department of Food and Nutrition, Kyoto Women's University, Kyoto, Japan
| | - Tomoko Wakamura
- Nursing Science, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Osamu Takeuchi
- Department of Medical Chemistry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoichiro Kamatani
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuo Chin
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
- Department of Sleep Medicine and Respiratory Care, Division of Respiratory Medicine, Nihon University of Medicine, 1-30, Uemachi Otaniguchi Itabashi-Ku, Tokyo, 173-8610, Japan.
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Ohira A, Yamakawa T, Iwahashi N, Tanaka S, Sugiyama M, Harada M, Ichikawa M, Akiyama T, Orime K, Terauchi Y. Association of continuous positive airway pressure therapy on cardiac hypertrophy in patients with sleep apnea comorbid with type 2 diabetes mellitus. Endocr J 2023; 70:47-58. [PMID: 36089339 DOI: 10.1507/endocrj.ej22-0308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Previous reports indicated the therapeutic effect of chronic continuous positive airway pressure (CPAP) therapy on cardiac hypertrophy due to sleep apnea syndrome. However, little is known for cases involving diabetic complications. This retrospective observational study examined the effects of CPAP therapy on left ventricular hypertrophy (LVH) in patients with obstructive sleep apnea syndrome (OSAS) and type 2 diabetes mellitus (T2DM). For all cases, the observation period was 3 years from the time when the patient was introduced to CPAP therapy. Overall, 123 patients were divided into a good CPAP group (CPAP ≥4 h/day, n = 63) and non-adherence group (CPAP <4 h/day, n = 60). The mean CPAP usage times were 5.58 ± 1.23 and 1.03 ± 1.17 h/day in the good CPAP and non-adherence groups, respectively. Regression tendencies of the thickness of the left ventricular posterior (-0.30 ± 1.19 mm) and interventricular septal walls (-0.48 ± 1.22 mm) were observed in the good CPAP group. Hypertrophic tendencies of the left ventricular posterior wall (+0.59 ± 1.44 mm) and interventricular septal wall thickness (+0.59 ± 1.43) were observed in the non-adherence group. Left ventricular posterior wall thickness (coefficient: -0.254, p = 0.0376) and interventricular septal wall thickness (coefficient: -0.426, p = 0.0006) were more likely to be greater in the non-adherence group than in the good CPAP group. Patients in the non-adherence group with an apnea hypopnea index ≥30 had increased left ventricular posterior wall thickness (coefficient: -0.263, p = 0.0673) and interventricular septal wall thickness (coefficient: -0.450, p = 0.0011). In conclusion, appropriate CPAP therapy is an effective treatment for LVH in patients with T2DM and OSAS, especially for severe cases.
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Affiliation(s)
- Akeo Ohira
- Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Tadashi Yamakawa
- Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Noriaki Iwahashi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | | | - Mai Sugiyama
- Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Marina Harada
- Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Masahiro Ichikawa
- Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Tomoaki Akiyama
- Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Kazuki Orime
- Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Yasuo Terauchi
- Department of Endocrinology and Metabolism, Yokohama City University School of Medicine, Yokohama 236-0004, Japan
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Matsumoto T, Murase K, Tabara Y, Minami T, Kanai O, Takeyama H, Sunadome H, Nagasaki T, Takahashi N, Nakatsuka Y, Hamada S, Handa T, Tanizawa K, Nakamoto I, Wakamura T, Komenami N, Setoh K, Kawaguchi T, Tsutsumi T, Morita S, Takahashi Y, Nakayama T, Sato S, Hirai T, Matsuda F, Chin K. Sleep disordered breathing and haemoglobin A1c levels within or over normal range and ageing or sex differences: the Nagahama study. J Sleep Res 2022; 32:e13795. [PMID: 36437403 DOI: 10.1111/jsr.13795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/12/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022]
Abstract
Recently an association between blood glucose dysregulation and sleep disruption was suggested. The association between sleep disordered breathing, most of which is due to obstructive sleep apnea (OSA) in the general population, and diabetic severity, as well as the impact of antidiabetic treatment, remains unclear. This study aimed to investigate these associations as well as age and sex differences. This cross-sectional study evaluated 7,680 community participants as the main cohort (population-based cohort). OSA was assessed by the 3% oxygen desaturation index from pulse oximetry, which was corrected for sleep duration obtained by wrist actigraphy. For arguing the limitations for using pulse oximetry, 597 hospitalised patients, who were assessed by the apnea-hypopnea index from attended polysomnography, were also evaluated as the validation cohort (hospital-based cohort). Moderate-to-severe OSA was more prevalent as haemoglobin A1c (HbA1c) levels increased (<5.6%/5.6%-<6.5%/6.5%-<7.5%/≥7.5%, respectively) in both cohorts (p < 0.001), but only in those without antidiabetic treatment. The HbA1c level was an independent factor for moderate-to-severe OSA (population-based cohort, odds ratio [OR] 1.26, 95% confidence interval [CI] 1.10-1.45; hospital-based cohort, OR 1.69, 95% CI 1.22-2.33, per 1% increase). These associations were more prominent in the middle-aged (aged <60 years) than in the elderly (aged ≥60 years) and in women than in men in both cohorts. The prevalence of moderate-to-severe OSA in patients with antidiabetic treatment in the hospital-based cohort was ≥75% regardless of HbA1c levels. In conclusion, an association between the prevalence of OSA and HbA1c level even within or over the normal range was found only in patients without antidiabetic treatment and was more prominent in the middle-aged and in women.
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Affiliation(s)
- Takeshi Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
- Department of Respiratory Medicine Saiseikai‐Noe Hospital Osaka Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
- Graduate School of Public Health Shizuoka Graduate University of Public Health Shizuoka Japan
| | - Takuma Minami
- Department of Primary Care and Emergency Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Osamu Kanai
- Department of Respiratory Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Hirofumi Takeyama
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Hironobu Sunadome
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Tadao Nagasaki
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Naomi Takahashi
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Yoshinari Nakatsuka
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Satoshi Hamada
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Tomohiro Handa
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Kiminobu Tanizawa
- Department of Respiratory Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Isuzu Nakamoto
- Nursing Science, Human Health Sciences, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Tomoko Wakamura
- Nursing Science, Human Health Sciences, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Naoko Komenami
- Department of Food and Nutrition Kyoto Women's University Kyoto Japan
| | - Kazuya Setoh
- Center for Genomic Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Takanobu Tsutsumi
- Center for Genomic Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Yoshimitsu Takahashi
- Department of Health Informatics Kyoto University School of Public Health Kyoto Japan
| | - Takeo Nakayama
- Department of Health Informatics Kyoto University School of Public Health Kyoto Japan
| | - Susumu Sato
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
| | - Kazuo Chin
- Center for Genomic Medicine, Graduate School of Medicine Kyoto University Kyoto Japan
- Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine Nihon University of Medicine Tokyo Japan
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Ito K, Uetsu M, Ubara A, Matsuda A, Sumi Y, Kadotani H. Obstructive Sleep Apnoea Severity Is Negatively Associated with Depressive Symptoms: A Cross-Sectional Survey of Outpatients with Suspected Obstructive Sleep Apnoea in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5007. [PMID: 35564403 PMCID: PMC9099749 DOI: 10.3390/ijerph19095007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/12/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023]
Abstract
Background: Multiple clinical departments are involved in the provision of obstructive sleep apnoea (OSA) therapy in Japan. Inconsistent results regarding the association between depression and OSA have been reported. Methods: This cross-sectional survey compared newly diagnosed OSA patients at two outpatient sleep apnoea units in Shiga Prefecture, Japan: one associated with the psychiatry department (n = 583), and the other with the otolaryngology department (n = 450). Results: The unit associated with the psychiatry department had more patients referred by psychiatrists than that with the otolaryngology department (11% vs. 3% p < 0.05). Sleepiness, insomnia, and depression were assessed using the Epworth Sleepiness Scale (ESS), Athens Insomnia Scale (AIS), and Patient Health Questionnaire-9 (PHQ-9), respectively. The ESS, AIS, and PHQ-9 scores were higher in the sleep unit in the psychiatry department (p < 0.001 each). Snoring and moderate to severe OSA were more prevalent in the unit attached to the otolaryngology department (p < 0.001 each). Patients with moderate to severe OSA had lower PHQ-9 scores than those with no to mild OSA (OR: 0.96, 95% CI: 0.92−1.00, p = 0.042). Conclusion: Patients with sleepiness, insomnia, and depressive symptoms were more likely to attend a sleep outpatient unit associated with a psychiatry department, whereas those with snoring and sleep apnoea attended that associated with an otolaryngology department. OSA severity was negatively associated with depressive symptoms.
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Affiliation(s)
- Kazuki Ito
- Department of Anesthesiology, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu 520-2192, Japan;
| | - Masahiro Uetsu
- Sleep Outpatient Unit for Sleep Apnea Syndrome, Nagahama City Hospital, 313 Ohinui-Cho, Nagahama 526-0043, Japan;
| | - Ayaka Ubara
- Department of Psychiatry, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu 520-2192, Japan; (A.U.); (A.M.); (Y.S.)
- Graduate School of Psychology, Doshisha University, Kyoto 610-0394, Japan
- Japan Society for the Promotion of Science, Research Fellowships, Tokyo 102-0083, Japan
| | - Arichika Matsuda
- Department of Psychiatry, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu 520-2192, Japan; (A.U.); (A.M.); (Y.S.)
| | - Yukiyoshi Sumi
- Department of Psychiatry, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu 520-2192, Japan; (A.U.); (A.M.); (Y.S.)
| | - Hiroshi Kadotani
- Sleep Outpatient Unit for Sleep Apnea Syndrome, Nagahama City Hospital, 313 Ohinui-Cho, Nagahama 526-0043, Japan;
- Department of Psychiatry, Shiga University of Medical Science, Seta-Tsukinowa-Cho, Otsu 520-2192, Japan; (A.U.); (A.M.); (Y.S.)
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5
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Kadotani H. Japanese clinical guideline for sleep apnea syndrome (SAS). Sleep Biol Rhythms 2022; 20:3. [PMID: 38469070 PMCID: PMC10899961 DOI: 10.1007/s41105-021-00358-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Shiga 520-2192 Japan
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