Influence of Impaired Diffusing Capacity and Sleep-disordered Breathing on Nocturnal Hypoxemia and Health Outcomes in Men with and without Human Immunodeficiency Virus.

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  • Additional Information
    • Source:
      Publisher: American Thoracic Society Country of Publication: United States NLM ID: 101600811 Publication Model: Print Cited Medium: Internet ISSN: 2325-6621 (Electronic) Linking ISSN: 23256621 NLM ISO Abbreviation: Ann Am Thorac Soc Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York, NY : American Thoracic Society, [2013]-
    • Subject Terms:
      Hypoxia*/physiopathology ; Polysomnography* ; Sleep Apnea Syndromes*/physiopathology ; Sleep Apnea Syndromes*/complications ; HIV Infections*/complications ; HIV Infections*/physiopathology ; Pulmonary Diffusing Capacity* ; Oximetry*; Humans ; Male ; Middle Aged ; Adult ; Oxygen Saturation ; Hypertension/physiopathology ; Hypertension/complications ; Hypertension/epidemiology ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/physiopathology ; Multivariate Analysis ; United States/epidemiology ; Carbon Monoxide/metabolism
    • Abstract:
      Rationale: Nocturnal hypoxemia is common in sleep-disordered breathing (SDB) and is associated with increased morbidity and mortality. Although impaired diffusing capacity of the lung for carbon monoxide (Dl CO ) is associated with daytime hypoxemia, its influence on SDB-related nocturnal hypoxemia is not known. Objectives: To characterize the effects of Dl CO impairment on SDB-related nocturnal hypoxemia and associated health outcomes. Methods: Data from a multicenter cohort of men with and without human immunodeficiency virus (HIV) infection, with concomitant measures of Dl CO and home-based polysomnography ( n  = 544), were analyzed. Multivariable quantile regression models characterized associations between Dl CO and several measures of SDB-related hypoxemia (e.g., total sleep time with oxygen saturation as measured by pulse oximetry [Sp O 2 ] < 90% [T90]). Structural equation models were used to assess associations of impaired Dl CO and SDB-related hypoxemia measures with prevalent hypertension and type 2 diabetes. Results: Dl CO impairment (<80% predicted) was associated with sleep-related hypoxemia. Participants with severe SDB (apnea-hypopnea index ⩾ 30 events/h) and impaired Dl CO had higher T90 (median difference, 15.0% [95% confidence interval (CI), 10.3% to 19.7%]) and average SDB-related desaturation (median difference, 1.0 [95% CI, 0.5 to 1.5]) and lower nadir Sp O 2 (median difference, -8.2% [95% CI, -11.4% to -4.9%]) and average Sp O 2 during sleep (median difference, -1.1% [95% CI, -2.1% to -0.01%]) than those with severe SDB and preserved Dl CO . Higher T90 was associated with higher adjusted odds of prevalent hypertension (odds ratio, 1.39 [95% CI, 1.14 to 1.70]) and type 2 diabetes (odds ratio, 1.25 [95% CI, 1.07 to 1.46]). Conclusions: Dl CO impairment in severe SDB was associated with sleep-related hypoxemia, prevalent hypertension, and type 2 diabetes. Assessment of SDB should be considered in those with impaired Dl CO to guide testing and risk stratification strategies.
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    • Grant Information:
      HL117167 United States HL NHLBI NIH HHS; K23 HL118414 United States HL NHLBI NIH HHS; U01 HL146245 United States HL NHLBI NIH HHS; U01 HL146208 United States HL NHLBI NIH HHS; UL1 TR001409 United States TR NCATS NIH HHS; KL2 TR001432 United States TR NCATS NIH HHS; U01 HL146192 United States HL NHLBI NIH HHS; U01 HL146242 United States HL NHLBI NIH HHS; TL1 TR001431 United States TR NCATS NIH HHS; U01 HL146193 United States HL NHLBI NIH HHS; R01 HL146709 United States HL NHLBI NIH HHS; U01 HL146241 United States HL NHLBI NIH HHS; P30 AI027767 United States AI NIAID NIH HHS; P30 AI050409 United States AI NIAID NIH HHS; U01 HL146333 United States HL NHLBI NIH HHS; U01 HL146205 United States HL NHLBI NIH HHS; P30 MH116867 United States MH NIMH NIH HHS; K12 HL143957 United States HL NHLBI NIH HHS; R01 HL117167 United States HL NHLBI NIH HHS; P30 AI073961 United States AI NIAID NIH HHS; U01 HL146201 United States HL NHLBI NIH HHS; U01 HL146204 United States HL NHLBI NIH HHS; K23 HL164151 United States HL NHLBI NIH HHS; U01 HL146202 United States HL NHLBI NIH HHS; UL1 TR001881 United States TR NCATS NIH HHS; U01 HL146240 United States HL NHLBI NIH HHS; U01 HL146194 United States HL NHLBI NIH HHS; R01 HL154860 United States HL NHLBI NIH HHS; U01 HL146203 United States HL NHLBI NIH HHS; UL1 TR003098 United States TR NCATS NIH HHS; P30 AI050410 United States AI NIAID NIH HHS
    • Contributed Indexing:
      Keywords: impaired DlCO; impaired diffusing capacity of the lung for carbon monoxide; nocturnal hypoxemia; sleep-disordered breathing
    • Accession Number:
      7U1EE4V452 (Carbon Monoxide)
    • Publication Date:
      Date Created: 20240318 Date Completed: 20240701 Latest Revision: 20240828
    • Publication Date:
      20240830
    • Accession Number:
      PMC11284323
    • Accession Number:
      10.1513/AnnalsATS.202309-757OC
    • Accession Number:
      38498872