Elevated Glycemic Variability Increases Risk of AF and Mortality in OSA: Study
Researchers have discovered in a new study that patients with obstructive sleep apnea (OSA) who have a high glycemic variability (GV) index show a significantly increased risk of developing atrial fibrillation (AF) and experiencing in-hospital mortality. These findings highlight the importance of personalized glycemic management strategies to improve oObstructive sleep apnea (OSA) has seen a rising prevalence and is closely linked with various cardiovascular diseases. Fluctuations in blood sugar levels, known as glycemic variability (GV), are linked to negative cardiovascular outcomes. The objective of this research is to explore how fluctuations in blood sugar levels affect the occurrence of atrial fibrillation (AF) and the rate of mortality during hospitalisation in individuals with obstructive sleep apnea.
This study conducted a retrospective analysis of patients diagnosed with obstructive sleep apnea based on the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database (version 2.2) covering the 2008-2019 period. The relationship between glycemic variability and outcomes such as atrial fibrillation and in-hospital mortality was assessed through restricted cubic spline (RCS) models and logistic regression (LR), with atrial fibrillation and in-hospital mortality as the primary endpoints. The differences in the risk of atrial fibrillation and in-hospital mortality across various levels of glycemic variability were examined using Kaplan-Meier (K-M) survival analysis. Additionally, subgroup analyses were performed to further explore these correlations.
The research involved 6,189 individuals, with a mean age of 64 years old, 36% of whom were women. Among the cohort, 176 patients (2.8%) died during hospitalization, and 673 patients developed atrial fibrillation in the hospital. The analysis using LR revealed a notable link between the glycemic variability index and both the risk of atrial fibrillation and in-hospital mortality among obstructive sleep apnea patients. According to the RCS model, there was a clear dose-response relationship, revealing that higher values of the glycemic variability index corresponded to a heightened risk of atrial fibrillation and in-hospital mortality. Moreover, analysis using the K-M method showed that there were notable statistical variations in the risks of AF and mortality among obstructive sleep apnea patients, stratified by quartiles of the glycemic variability index.
Patients with obstructive sleep apnea who have an elevated glycemic variability index face a significantly higher risk of both atrial fibrillation and mortality during hospitalisation, underscoring the importance of developing personalised glycemic management strategies to improve patient outcomes.
Reference:
Li, Panxiao, et al. "Correlation of Glycemic Variability With the Risk of Atrial Fibrillation and In-hospital Mortality in Patients Diagnosed With Obstructive Sleep Apnea: a Retrospective Study Based On the Medical Information Mart for Intensive Care Database." Journal of Thoracic Disease, vol. 18, no. 2, 2026, p. 76.
Keywords:
Elevated, Glycemic, Variability, Increases, Risk of AF, Mortality, OSA, Study, Li, Panxiao, Journal of Thoracic Disease
