{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:42:14Z","timestamp":1787503334603,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims\/Introduction<\/jats:title>\n                    <jats:p>Obstructive sleep apnea (OSA) is a multifaceted condition that may variably influence metabolic risk. This study aimed to identify physiological phenotypes of OSA using polysomnographic (PSG) data and examine their association with type 2 diabetes (T2DM) in a Japanese cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Among 3,683 individuals who underwent attended PSG between April 2019 and March 2024, 602 adults with OSA were included. Phenotypes were identified by k\u2010means clustering. The association between phenotype and T2DM was assessed using logistic regression adjusted for covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five phenotypes were identified: Severe desaturation, REM\u2010predominant, PLMS\u2010dominant, Sleep\u2010fragmented, and Mild. Severe desaturation and REM\u2010predominant types showed higher T2DM prevalence (54.5% and 45.7%). In multivariable analysis, both were independently associated with T2DM compared with the Mild type (adjusted odds ratio [OR] 5.00, 95% CI 1.52\u201316.4; and OR 3.12, 95% CI 1.32\u20137.38). To further explore the underlying mechanisms, logistic regression including all participants showed that CT90 was independently associated with T2DM, even after adjustment for arousal threshold and AHI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Data\u2010driven clustering identified distinct physiological phenotypes of OSA. In addition to the Severe desaturation type, the REM\u2010predominant type was also strongly associated with T2DM, underscoring the metabolic heterogeneity of OSA. Prospective studies are needed to determine causal relationships and evaluate phenotype\u2010targeted interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdi.70305","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T13:00:46Z","timestamp":1775653246000},"page":"1043-1051","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Physiological phenotypes of obstructive sleep apnea identified by cluster analysis: Association with type 2 diabetes"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7491-5259","authenticated-orcid":false,"given":"Saeko","family":"Osawa","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology Osaka Kaisei Hospital  Osaka Japan"},{"name":"Sleep Medical Center, Osaka Kaisei Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsutaka","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Sleep Medical Center, Osaka Kaisei Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0841-1005","authenticated-orcid":false,"given":"Naohiko","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Osaka Kaisei Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromitsu","family":"Tabata","sequence":"additional","affiliation":[{"name":"Sleep Medical Center, Osaka Kaisei Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoharu","family":"Ohi","sequence":"additional","affiliation":[{"name":"Sleep Medical Center, Osaka Kaisei Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics15091088"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41606-023-00094-0"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2024.111984"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2010.04.017"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2017.05.009"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.16059"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2017-210431"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S374572"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.09.002"},{"key":"e_1_2_10_11_1","unstructured":"AASM Scoring Manual \u2013 American Academy of Sleep Medicine.https:\/\/aasm.org\/clinical\u2010resources\/scoring\u2010manual\/. 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