The evaluation of risk for obstructive sleep apnea in patients with type 2 diabetes

Cilj istraživanja je procijeniti rizik za opstrukcijsku apneju tijekom spavanja (engl. Obstructive sleep apnea, OSA) u bolesnika sa šećernom bolešću tipa 2, s pomoću STOP upitnika (engl. Snoring, Tiredness, Observed, Pressure; STOP). S pomoću Epworthove ljestvice pospanosti (ESS) procijenjena je prekomjerna dnevna pospanost i ispitana povezanost pospanosti i rizika za OSA-u u bolesnika sa šećernom bolešću tipa 2. Dosadašnja istraživanja pokazala su da oštećena tolerancije glukoze i šećerna bolest tipa 2 predstavljaju čimbenik rizika za OSA-u, ali i da OSA predstavlja čimbenik rizika za šećernu bolest tipa 2. U našem istraživanju sudjelovala su 252 ispitanika sa šećernom bolešću tipa 2, koji su bili anketirani za vrijeme redovitih pregleda u Kliničkom bolničkom centru Split. Rezultati našeg istraživanja pokazali su da je 156 ispitanika (61,9%) imalo povećan rizik za OSA-u prema rezultatima STOP upitnika. Nadalje, ispitanici koji su imali povećani rizik u odnosu na ispitanike koji nisu imali rizik za OSA-u bili su stariji (65 vs. 61 godina, p < 0,05), imali viši indeks tjelesne mase (28,6 ± 5,1 vs. 26,5 ± 4,1, p < 0,001), veći opseg vrata (41,5 ± 4,7 vs. 39,6 ± 6,2, p < 0,009) i bili pospaniji prema rezultatima ESS (5,3 ± 3,1 vs. 3,9 ± 2,5, p < 0,001). Uz šećernu bolest, većina ispitanika imala je i pridružene bolesti: arterijska hipertenzija (46%), gastroezofagealna refluksna bolest (28%), depresija (10%) i astma (8%). OSA je dio širokoga spektra poremećaja disanja tijekom spavanja koja se dovodi u vezu s metaboličkim poremećajima poput šećerne bolesti tipa 2, a epidemiološki podaci o zastupljenosti OSA u Hrvatskoj su nedostatni. Ovo istraživanje ukazuje na potrebu provođenja probira za OSA u bolesnika sa šećernom bolešću tipa 2, koristeći STOP upitnik.The aim of this study was to evaluate the risk for obstructive sleep apnea (OSA) in patients with type 2 diabetes using the STOP questionnaire (Snoring, Tiredness, Observed, Pressure; STOP). Excessive daytime sleepiness was evaluated with the Epworth sleepiness scale (ESS). Previous studies support the idea that glucose intolerance and type 2 diabetes might represent risk factors for OSA, as well as the idea of OSA being the risk factor for type 2 diabetes. A total of 252 patients with type 2 diabetes were surveyed during the regular follow-up in the Regional Centre for Diabetes, Endocrinology and Metabolic Diseases of Split University Hospital. The results of our study indicate that 156 patients (61.9%) had increased risk for OSA according to STOP questionnaire score. In addition, those at high risk for OSA were older (65 vs. 61 years of age, p < 0.05), had higher body mass index (BMI, 28.6 ± 5.1 vs. 26.5 ± 4.1, p < 0.001), higher neck circumference (41.5 ± 4.7 vs. 39.6 ± 6.2, p < 0.009), and had excessive daytime sleepiness according to the ESS score (5.3 ± 3.1 vs. 3.9 ± 2.5, p < 0.001). Individuals with type 2 diabetes reported to have comorbidities, mainly hypertension (46%), gastroesophageal reflux disease (28%), depression (10%), and asthma (8%). Based on current evidence from literature, OSA could be related to clinical conditions such as diabetes and essential hypertension. More epidemiological data are needed to establish the prevalence of OSA in Croatian patients with type 2 diabetes. Our findings indicate the relevance of STOP questionnaire use as a screening tool for obstructive sleep apnea in patients with type 2 diabetes in Croatia

Exaptive origins of regulated mRNA decay in eukaryotes

Eukaryotic gene expression is extensively controlled at the level of mRNA stability and the mechanisms underlying this regulation are markedly different from their archaeal and bacterial counterparts. We propose that two such mechanisms, nonsense‐mediated decay (NMD) and motif‐specific transcript destabilization by CCCH‐type zinc finger RNA‐binding proteins, originated as a part of cellular defense against RNA pathogens. These branches of the mRNA turnover pathway might have been used by primeval eukaryotes alongside RNA interference to distinguish their own messages from those of RNA viruses and retrotransposable elements. We further hypothesize that the subsequent advent of “professional” innate and adaptive immunity systems allowed NMD and the motif‐triggered mechanisms to be efficiently repurposed for regulation of endogenous cellular transcripts. This scenario explains the rapid emergence of archetypical mRNA destabilization pathways in eukaryotes and argues that other aspects of post‐transcriptional gene regulation in this lineage might have been derived through a similar exaptation route