RT Journal Article SR Electronic T1 Sleep apnoea severity independently predicts glycaemic health in nondiabetic subjects: the ESADA study JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP erj01627-2013 DO 10.1183/09031936.00162713 A1 Brian D. Kent A1 Ludger Grote A1 Maria Bonsignore A1 Tarja Saaresranta A1 Johan Verbraecken A1 Patrick Lévy A1 Pawel Sliwinski A1 Ruzena Tkacova A1 John-Arthur Kvamme A1 Ingo Fietze A1 Jan Hedner A1 Walter T. McNicholas A1 on behalf of the European Sleep Apnoea Database collaborators YR 2014 UL http://erj.ersjournals.com/content/early/2014/04/02/09031936.00162713.abstract AB Obstructive sleep apnoea (OSA) is associated with increased risk of dysglycaemia but the intimate link of these conditions with obesity makes discerning an independent relationship between them challenging. Glycosylated haemoglobin (HbA1c) levels predict adverse cardiovascular outcomes in nondiabetics but there is a lack of population-level data exploring the relationship of HbA1c with OSA. A cross-sectional analysis of 5294 participants in the multinational European Sleep Apnoea Cohort (European Sleep Apnoea Database) study was performed, assessing the relationship of OSA severity with HbA1c levels in nondiabetic subjects, with adjustment for confounding factors. HbA1c levels correlated significantly with OSA severity in univariate analysis. Following adjustment for confounding factors, apnoea–hypopnoea index (AHI) (standardised β 0.158; p<0.001), along with nocturnal hypoxaemia, predicted HbA1c. Adjusted mean HbA1c levels were lower in the lowest AHI quartile (5.24%, 95% CI 5.21–5.27%) than in the second (5.37%, 95% CI 5.34–5.40%), third (5.44%, 95% CI 5.41–5.47%) or highest (5.50%, 95% CI 5.46–5.53%) quartiles. Subjects in the higher quartiles had significantly greater adjusted odds ratios of HbA1c level ≥6.0% than those in the first quartile. In stratified analyses, OSA severity predicted glycaemic health irrespective of sleep study modality, sex, obesity or daytime sleepiness. OSA severity independently predicts glycaemic health in nondiabetic subjects. Further studies should assess the impact of OSA treatment on glycaemic health and elucidate underlying mechanisms. Increasing sleep apnoea severity was associated with elevated HbA1c levels in a nondiabetic multinational cohort http://ow.ly/u1RLR