Unraveling the Novel Associations of Sleep Apnea with Glycosylated Hemoglobin: Insights from NHANES and Mendelian Randomization Analysis

Abstract

Abstract Background While sleep apnea (SA) has been identified as a risk factor for metabolic dysfunction in diabetes, further research is required to establish a causal relationship between alterations in glycosylated hemoglobin(HbA1C) and the presence of sleep apnea. Methods We utilized data from the National Health and Nutrition Examination Survey (NHANES) 2015–2018 and employed logistic regression models to analyze the association,Based on the questionnaire data, sleep apnea (SA) is categorized into three levels: Rarely−1−2 nights a week, Occasionally−3−4 nights a week, and Frequently−5 or more nights a week. Additionally, a two-sample Mendelian randomization (MR) study was conducted using genome-wide association study (GWAS) summary statistics to assess the causal relationship between sleep apnea and HbA1C. The primary analysis utilized the inverse variance weighted (IVW) method. Sensitivity analyses were also performed to ensure the robustness of our findings. Results In our cross-sectional analysis, after adjusting for multiple covariates, we observed an increased risk of HbA1C ratio for both "Occasionally−3−4 nights a week" (OR = 0.08, 95% CI = 0.00 ~ 0.15, P = 0.036) and "Frequently−5 or more nights a week" (OR = 0.09, 95% CI = 0.00 ~ 0.17, P = 0.045). Utilizing the IVW technique, we calculated the risk of sleep apnea on HbA1C to be (OR = 1.086, 95% CI = 0.89 ~ 0.96, P = 0.035). The MR sensitivity analysis generated consistent findings. Conclusion Sleep apnea is linked to a higher risk of elevated HbA1c. The MR analysis supports a potential causal effect of sleep apnea on HbA1c.