The bidirectional association between obstructive sleep apnea and diabetic kidney disease: systematic review and meta-analysis
Bibliographic record
Abstract
Objective: This study aims to comprehensively explore the bidirectional association between obstructive sleep apnea (OSA) and diabetic kidney disease (DKD) through a systematic review and meta-analysis. Method: Systematically search for relevant literature on the association between OSA and DKD published from database inception to September 2025. Searches were performed in the Cochrane Library, PubMed, Embase, and Web of Science. Study quality was assessed with the Newcastle-Ottawa Scale (NOS). Meta-analysis, sensitivity analysis, and publication bias assessment were conducted using Review Manager 5.4, while R software was employed to calculate prediction intervals. The certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework. Result: ) between DKD and non-DKD groups across all subgroup analyses (all P > 0.05). Conclusion: A significant bidirectional association exists between OSA and DKD, suggesting a mutual exacerbation of risks between the two conditions. These findings highlight the clinical importance of enhanced OSA screening in diabetic populations and regular renal function monitoring in OSA patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.044 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.017 | 0.033 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".