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Obstructive sleep apnea rather than diabetes or obesity associated with proteinuria in late mid-aged male workers: a decision tree analysis

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Abstract

Background

Both proteinuria and obstructive sleep apnea (OSA) are associated with cardiovascular events and consequent mortality. To examine whether age, OSA, diabetes, and obesity are potential predictors of proteinuria, a data-driven analysis was performed to delineate a potential categorical classification algorithm.

Methods

In this cross-sectional community-based cohort study, demographic data, blood pressure, serum biochemical analyses, proteinuria via single dipstick urinalysis, and overnight polysomnographies were measured in 300 males with sedentary work styles.

Results

Sixty-one (20.3 %) of all these participants had proteinuria. Logistic regression analysis showed that glycated hemoglobin (HbA1c), duration of arterial oxygen saturation <90 %, age, and log high-sensitivity C-reactive protein, but not apnea-hypopnea index (AHI), were responsible for 16.7 % of the variance of proteinuria’s presence. A decision tree analysis showed that subjects over 49 years old had a higher risk for proteinuria than those subjects of 49 years old, or less. In the over 49-year-old group, subjects with an AHI >21 events/h had a higher risk for proteinuria; whereas in the 49-year-old and less group, subjects with HbA1c >7 %, or with HbA1c ≤7, and body mass index (BMI) >27.4 kg/m2 had a higher risk for proteinuria than their counterparts.

Conclusions

AHI was the major determinant responsible for the presence of proteinuria in late mid-aged male workers, while HbA1c and BMI were found in the junior subgroup. By algorithmic analysis, this study provides a comprehensive hierarchical model for better understanding of the correlates of proteinuria and sleep apnea.

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Acknowledgments

This study is supported by grant NSC 98-2314-B-040-001-MY3 from the National Science Council, Taiwan and grant CMU99-COL-21 from China Medical University. This study is supported in part by the Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW104-TDU-B-212-113002). Research was supported by The Program for Professor of Special Appointment (Eastern Scholar, Honorary Chair Professor) at Shanghai Institute of Higher Education (No 2012–47). The authors thank Dr. Amy Lin, Mr. Michael Turton, and Dr. Timothy Williams for correcting the manuscript.

Conflict of interest

No conflict of interest for all authors.

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Author notes

    Authors and Affiliations

    1. Department of Physical Medicine and Rehabilitation, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan

      Hua Ting

    2. Center of Sleep Medicine, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan

      Hua Ting, Chih-Huan Wang, Shu-Yun Chang, Ai-Hui Chung, Jia-Fei Lee & Ren-Jing Huang

    3. Institute of Medicine, Chung-Shan Medical University, Taichung, Taiwan

      Hua Ting, Cher-Ming Liou & Shu-Yun Chang

    4. Department of Anesthesiology, Chung-Shan Medical University Hospital, Taichung, Taiwan

      Cher-Ming Liou

    5. Institute of Occupational Safety and Health Council of Labor Affairs, Executive Yuan, Taipei, Taiwan

      Tung-Sheng Shih

    6. Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan

      Tung-Sheng Shih

    7. Department of Psychology, National Chengchi University, Taipei, Taiwan

      Chih-Huan Wang

    8. Department of Public Health, Chung-Shan Medical University, Taichung, Taiwan

      Lee Wang

    9. Department of Medical Image and Radiological Sciences, Chung-Shan Medical University, Taichung, Taiwan

      Ren-Jing Huang

    10. Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, 91 Hsueh-Shih Road, Taichung, 40202, Taiwan

      Shin-Da Lee

    11. Department of Healthcare Administration, Asia University, Taichung, Taiwan

      Shin-Da Lee

    12. School of Rehabilitation Medicine, Shanghai University of TCM, Shanghai, China

      Shin-Da Lee

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    1. Hua Ting
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    Correspondence to Shin-Da Lee.

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    Ren-Jing Huang and Shin-Da Lee share equal contribution.

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    Ting, H., Liou, CM., Shih, TS. et al. Obstructive sleep apnea rather than diabetes or obesity associated with proteinuria in late mid-aged male workers: a decision tree analysis. Sleep Breath 19, 1167–1174 (2015). https://doi.org/10.1007/s11325-015-1132-z

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    • DOI: https://doi.org/10.1007/s11325-015-1132-z

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