1. Independent Association Between Obstructive Sleep Apnea Severity and Glycated Hemoglobin in Adults Without Diabetes Featured Article: Pascaline Priou, M.D., Marc Le Vaillant, Ph.D., Nicole Meslier, M.D., Sylvaine Chollet, M.D., Philippe Masson, M.D., Marie P. Humeau, M.D., Thierry Pigeanne, M.D., Acya Bizieux-Thaminy, M.D., François Goupil, M.D., Frédéric Gagnadoux, M.D., Ph.D., The IRSR Sleep Cohort Group Diabetes Care Volume 35: 1902-1906 September, 2012

2. Study Objective To test the hypothesis of an independent cross-sectional association between obstructive sleep apnea (OSA) severity and glycated hemoglobin (HbA1c) in adults without known diabetes Priou P et al. Diabetes Care 2012;35:1902-1906

3. Study Design & Methods HbA 1c measured in whole-blood samples from 2,139 patients undergoing nocturnal recording for suspected OSA Participants with self-reported diabetes, use of diabetes medication, or HbA 1c value ≥6.5% excluded from study Final sample size comprised 1,599 patients Priou P et al. Diabetes Care 2012;35:1902-1906

4. Results Dose-response relationship observed between apnea- hypopnea index (AHI) and the percentage of patients with HbA 1c >6.0%, ranging from 10.8% for AHI <5 to 34.2% for AHI ≥50 After adjusting for age, sex, smoking habits, BMI, waist circumference, cardiovascular morbidity, daytime sleepiness, depression, insomnia, sleep duration, and study site, odds ratios (95% CIs) for HbA 1c >6.0% were as follows: o 1 (reference) for AHI values <5 o 1.40 (0.84–2.32) for values 5 to <15 o 1.80 (1.19–2.72) for values 15 to <30 o 2.02 (1.31–3.14) for values 30 to <50 o 2.96 (1.58–5.54) for values ≥50 Increasing hypoxemia during sleep was independently associated with the odds of HbA 1c >6.0% Priou P et al. Diabetes Care 2012;35:1902-1906

8. Conclusions In adults without known diabetes, increasing OSA severity independently associated with impaired glucose metabolism, as assessed by higher HbA1c values Impaired glucose metabolism may expose adults to a higher risk of diabetes and cardiovascular disease Priou P et al. Diabetes Care 2012;35:1902-1906