Risks of peripheral arterial occlusive disease in patients with obstructive sleep apnoea: a population-based case-control study

Objectives This study aimed to evaluate the risk of peripheral arterial occlusive disease (PAOD) in patients with obstructive sleep apnoea (OSA) using a nationwide claim database in Taiwan. Design A population-based case-control study. Setting Data from the Longitudinal Health Insurance Database 2000 of the Taiwan's National Health Insurance Research Database. Participants Eleven thousand eight hundred and seventeen adult patients diagnosed with PAOD between January 1, 2001 and December 31, 2010 and 35451 controls without PAOD frequency matched by sex, 10-year age interval and year of index date. Main outcome measures Obstructive sleep apnoea and a number of comorbidities prior to the index date were assessed and analysed with logistic regression analyses. Results Univariate logistic regression analysis showed that PAOD was significantly associated with OSA (odds ratio, OR=1.60, P<0.001). Multivariate logistic regression analysis, adjusted for coronary artery disease or myocardial infarction, chronic kidney disease, hyperurecaemia and obesity, also showed that PAOD was significantly associated with OSA (adjusted OR=1.37, P=0.014). However, the association was attenuated when it was further adjusted for hypertension, hyperlipidaemia and diabetes mellitus (DM). Conclusion Findings from this nationwide population-based study indicated that PAOD was significantly associated with OSA. Further studies are warranted to determine whether OSA may contribute to the development of PAOD indirectly via increasing the risks of hypertension, hyperlipidaemia and/or DM.