Type I diabetes: a new risk factor for obstructive sleep apnea
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"tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "53" "paginaFinal" => "54" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Geraldo Lorenzi-Filho, Luciano F. Drager" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Geraldo" "apellidos" => "Lorenzi-Filho" "email" => array:1 [ 0 => "geraldo.lorenzi@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Luciano F." "apellidos" => "Drager" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Pulmonary Division, Sleep Laboratory; Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Hypertension Unit, Heart Institute (InCor), Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brasil" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "correspondencia" => "Corresponding author. geraldo.lorenzi@gmail.com" ] ] ] ] "textoCompleto" => "<p class="elsevierStylePara">Obstructive sleep apnea (OSA) is common in the general population but remains largely under recognized.<a href="#bib1" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a> Risk factors for OSA include male gender, obesity and increasing age.<a href="#bib1" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">, </span><a href="#bib2" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a> There is growing evidence that OSA may cause several consequences including not only poor sleep quality and excessive daytime sleepiness but also contribute to detrimental cardiometabolic consequences.<a href="#bib3" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a><span class="elsevierStyleSup">, </span><a href="#bib4" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a> Therefore, recognizing populations that are at increased risk should help to detect OSA. In the present number of the Portuguese Journal of Pulmonology, Vale and colleagues provide novel evidence suggesting that type I diabetes is strongly associated with OSA.<a href="#bib5" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a> The authors used portable monitoring to evaluate the presence of sleep disordered breathing among 46 adults with diabetes, divided in 23 with type I and 23 type II diabetes. Because OSA and type II diabetes share several common risk factors such as obesity, it is not surprising that OSA was extremely frequent in this population. This finding is therefore in line with several studies and point out to the low levels of OSA recognition among patients with type 2 diabetes.<a href="#bib3" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a> Vale and colleagues took a step forward and showed a similar high frequency of OSA among adult patients with type I diabetes as compared with those with type II diabetes. Despite the fact that the patients with type I were not particularly obese (mean body mass index of 28 kg/m<span class="elsevierStyleSup">2</span>) and were in fact much younger than those with type II diabetes (mean age of 39 vs 62 years old, respectively) the frequency of OSA was similar among the two groups and ranged from 26 to 70% depending of the apnea hypopnea index criterion for OSA definition. The study is therefore in line with recent evidence pointing out that not only type II diabetes, but also type I diabetes is associated with a high prevalence of OSA.<a href="#bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">6</span></a><span class="elsevierStyleSup">, </span><a href="#bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">7</span></a> Another important message of the study of Vale and colleagues was that there was no association between OSA and complaints of excessive daytime sleepiness among patients with diabetes. In contrast to patients referred to sleep laboratories, among consecutive patients with cardiovascular diseases such as hypertension as well among those with metabolic syndrome and diabetes, the association between OSA and excessive daytime sleepiness is very poor or non- existent.<a href="#bib4" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">, </span><a href="#bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a> This raises one important question: What is the real significance of an altered sleep study among patients with no overt symptoms? The current working hypothesis is that OSA is more than a common condition but when present contributes to poor cardiovascular and metabolic outcome.<a href="#bib3" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a> The primary mechanisms that are deleterious to the cardiovascular and metabolic system includes increased negative intrathoracic pressure during the efforts for breath against an occluded airway, arousals from sleep and intermittent hypoxia. There is growing evidence that these primary events that occur during sleep trigger a cascade of detrimental effects, including increased sympathetic activity, oxidative stress, metabolic deregulation such as insulin resistance and lipid dysfunction, endothelial dysfunction and accelerated atherosclerosis.<a href="#bib3" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a> Consistent with the hypothesis that OSA may contribute to poor glicemic control, Vale and colleagues found that the AHI was significantly lower and in the normal range among patients with type II diabetes and normal glycosylated hemoglobin (HbA1c) as compared to patients with type II diabetes and elevated HbA1C. The serum level of HbA1C is known to reflect average glycemia over the preceding 2–3 months and therefore one possible conclusion is that OSA contributed to poor glicemic control. The interpretation of such cross sectional data is, however, limited and the authors acknowledged that due to the relatively small sample they were under powered to correct for confounding variables. There is some evidence that OSA treatment promotes better glucose control in type 2 diabetes.<a href="#bib9" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">9</span></a> Future randomized studies are necessary in order to evaluate whether treatment of OSA contributes to a better control of type I diabetes. Another important aspect that the study of Vale and colleagues raises is the relationship between type I diabetes and sleep. It must be stressed that type I diabetes and glicemic control may affect circadian rhythms, sleep duration and quality of sleep.<a href="#bib10" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">10</span></a> Therefore the interaction of such factors may go far beyond OSA. One attractive hypothesis is that diabetes may cause subtle alterations in the upper airway function. Consistent with this hypothesis, diabetes was recently associated with decreased nasal mucociliary function.<a href="#bib11" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">11</span></a> Although not directly related to OSA pathogenesis, it raises the hypothesis that other functions such as upper airway neuro reflexes that are important to stabilize the upper airway during sleep are impaired among patients with long lasting type I diabetes. Recent studies showed that OSA was independently associated with macrovascular complications, retinopathy as well as cardiovascular autonomic neuropathy among patients with type I diabetes.<a href="#bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">7</span></a><span class="elsevierStyleSup">, </span><a href="#bib12" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">12</span></a> Therefore, OSA could also be seen as a complication of diabetes. Independent of the exact mechanism linking type I diabetes to OSA, the study of Vale and colleagues contribute to the hypothesis that OSA should be actively searched not only among patients with type II diabetes but also among those with type I diabetes.</p><p class="elsevierStylePara">Corresponding author. geraldo.lorenzi@gmail.com</p>" "pdfFichero" => "320v21n02a90393302pdf001.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:12 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med. 2010; 11(5):441-6." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Tufik S" 1 => "Santos-Silva R" 2 => "Taddei JA" 3 => "Bittencourt LR." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.sleep.2009.10.005" "Revista" => array:6 [ "tituloSerie" => "Sleep Med. " "fecha" => "2010" "volumen" => "11" "paginaInicial" => "441" "paginaFinal" => "446" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20362502" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Upper airway collapsibility is associated with obesity and hyoid position Sleep. 2014; 37(10):1673-8." "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Genta PR" 1 => "Schorr F" 2 => "Eckert DJ" 3 => "Gebrim E" 4 => "Kayamori F" 5 => "Moriya HT" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5665/sleep.4078" "Revista" => array:6 [ "tituloSerie" => "Upper airway collapsibility is associated with obesity and hyoid position Sleep. " "fecha" => "2014" "volumen" => "37" "paginaInicial" => "1673" "paginaFinal" => "1678" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25197805" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Obstructive sleep apnea: a cardiometabolic risk in obesity and the metabolic syndrome. J Am Coll Cardiol. 2013; 62(7):569-76." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Obstructive sleep apnea: a cardiometabolic risk in obesity and the metabolic syndrome." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Drager LF" 1 => "Togeiro SM" 2 => "Polotsky VY" 3 => "Lorenzi-Filho G." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2013.05.045" "Revista" => array:7 [ "tituloSerie" => "J Am Coll Cardiol. " "fecha" => "2013" "volumen" => "62" "paginaInicial" => "569" "paginaFinal" => "576" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23770180" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673613626756" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Atherosclerosis. The incremental role of obstructive sleep apnoea on markers of atherosclerosis in patients with metabolic syndrome. Atherosclerosis. 2010; 208(2):490-5." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Atherosclerosis. The incremental role of obstructive sleep apnoea on markers of atherosclerosis in patients with metabolic syndrome." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Drager LF" 1 => "Bortolotto LA" 2 => "Maki-Nunes C" 3 => "Trombetta IC" 4 => "Alves MJ" 5 => "Fraga RF" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.atherosclerosis.2009.08.016" "Revista" => array:6 [ "tituloSerie" => "Atherosclerosis. " "fecha" => "2010" "volumen" => "208" "paginaInicial" => "490" "paginaFinal" => "495" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19762024" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Vale J, Manuel P, Oliveira E, Oliveira AR, Silva E, Melo V, et al. Obstructive sleep apnea and diabetes mellitus. Rev Port Pneumol. http://dx.doi.org/10.1016/j.rppnen.2014.07.005." "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vale J, Manuel P, Oliveira E, Oliveira AR, Silva E, Melo V, et al. Obstructive sleep apnea and diabetes mellitus. Rev Port Pneumol. http://dx.doi.org/10.1016/j.rppnen.2014.07.005." "idioma" => "pt" ] ] "host" => array:1 [ 0 => array:1 [ "WWW" => array:1 [ "link" => "Vale J, Manuel P, Oliveira E, Oliveira AR, Silva E, Melo V, et al. Obstructive sleep apnea and diabetes mellitus. Rev Port Pneumol. http://dx.doi.org/10.1016/j.rppnen.2014.07.005." ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "High prevalence of obstructive sleep apnoea syndrome in a Type 1 diabetic adult population: a pilot study. Diabet Med. 2010; 27(11):1328-9." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "High prevalence of obstructive sleep apnoea syndrome in a Type 1 diabetic adult population: a pilot study." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Borel AL" 1 => "Benhamou PY" 2 => "Baguet JP" 3 => "Halimi S" 4 => "Levy P" 5 => "Mallion JM" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1464-5491.2010.03096.x" "Revista" => array:6 [ "tituloSerie" => "Diabet Med. " "fecha" => "2010" "volumen" => "27" "paginaInicial" => "1328" "paginaFinal" => "1329" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20950392" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Obstructive sleep apnoea in people with Type 1 diabetes: prevalence and association with micro- and macrovascular complications. Diabet Med. 2015; 32(1):90-6." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Obstructive sleep apnoea in people with Type 1 diabetes: prevalence and association with micro- and macrovascular complications." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Manin G" 1 => "Pons A" 2 => "Baltzinger P" 3 => "Moreau F" 4 => "Iamandi C" 5 => "Wilhelm JM" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/dme.12582" "Revista" => array:7 [ "tituloSerie" => "Diabet Med. " "fecha" => "2015" "volumen" => "32" "paginaInicial" => "90" "paginaFinal" => "96" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25186832" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1098301512041320" "estado" => "S300" "issn" => "10983015" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Characteristics and predictors of obstructive sleep apnea in patients with systemic hypertension. Am J Cardiol. 2010; 105(8):1135-9." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Characteristics and predictors of obstructive sleep apnea in patients with systemic hypertension." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Drager LF" 1 => "Genta PR" 2 => "Pedrosa RP" 3 => "Nerbass FB" 4 => "Gonzaga CC" 5 => "Krieger EM" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjcard.2009.12.017" "Revista" => array:6 [ "tituloSerie" => "Am J Cardiol. " "fecha" => "2010" "volumen" => "105" "paginaInicial" => "1135" "paginaFinal" => "1139" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20381666" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea. Arch Intern Med. 2005; 165(4):447-52." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Babu AR" 1 => "Herdegen J" 2 => "Fogelfeld L" 3 => "Shott S" 4 => "Mazzone T." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archinte.165.4.447" "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med. " "fecha" => "2005" "volumen" => "165" "paginaInicial" => "447" "paginaFinal" => "452" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15738376" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Type 1 Diabetes associated with sleep disorders. Sleep Science. 2009; 2(2):96-8." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Type 1 Diabetes associated with sleep disorders." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Barone MTU" 1 => "Menna-Barreto L." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Sleep Science. " "fecha" => "2009" "volumen" => "2" "paginaInicial" => "96" "paginaFinal" => "98" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Aging, diabetes, and hypertension are associated with decreased nasal mucociliary clearance. Chest. 2013; 143(4):1091-7." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Aging, diabetes, and hypertension are associated with decreased nasal mucociliary clearance." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "de Oliveira-Maul JP" 1 => "de Carvalho HB" 2 => "Miyuki Goto D" 3 => "Mendonça Maia R" 4 => "Fló C" 5 => "Barnabé V" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.12-1183" "Revista" => array:6 [ "tituloSerie" => "Chest. " "fecha" => "2013" "volumen" => "143" "paginaInicial" => "1091" "paginaFinal" => "1097" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23100111" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Front Endocrinol (Lausanne). Cardiovascular autonomic neuropathy contributes to sleep apnea in young and lean type 1 diabetes mellituspatients. Front Endocrinol (Lausanne). 2014; 5:119." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Front Endocrinol (Lausanne). Cardiovascular autonomic neuropathy contributes to sleep apnea in young and lean type 1 diabetes mellituspatients." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Janovsky CC" 1 => "Rolim LC" 2 => "de Sá JR" 3 => "Poyares D" 4 => "Tufik S" 5 => "Silva AB" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fendo.2014.00119" "Revista" => array:5 [ "tituloSerie" => "Front Endocrinol (Lausanne). " "fecha" => "2014" "volumen" => "5" "paginaInicial" => "119" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25157241" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08732159/0000002100000002/v0_201604141148/X0873215915933025/v0_201604141148/en/main.assets" "Apartado" => array:4 [ "identificador" => "18132" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Editoriais" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000002100000002/v0_201604141148/X0873215915933025/v0_201604141148/en/320v21n02a90393302pdf001.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0873215915933025?idApp=UINPBA00004E" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 13 | 3 | 16 |
| 2024 October | 54 | 44 | 98 |
| 2024 September | 44 | 48 | 92 |
| 2024 August | 63 | 48 | 111 |
| 2024 July | 52 | 37 | 89 |
| 2024 June | 52 | 51 | 103 |
| 2024 May | 58 | 34 | 92 |
| 2024 April | 58 | 27 | 85 |
| 2024 March | 47 | 27 | 74 |
| 2024 February | 46 | 24 | 70 |
| 2024 January | 50 | 28 | 78 |
| 2023 December | 35 | 27 | 62 |
| 2023 November | 40 | 27 | 67 |
| 2023 October | 31 | 32 | 63 |
| 2023 September | 32 | 33 | 65 |
| 2023 August | 34 | 18 | 52 |
| 2023 July | 37 | 30 | 67 |
| 2023 June | 31 | 22 | 53 |
| 2023 May | 55 | 25 | 80 |
| 2023 April | 40 | 22 | 62 |
| 2023 March | 75 | 17 | 92 |
| 2023 February | 59 | 19 | 78 |
| 2023 January | 34 | 17 | 51 |
| 2022 December | 57 | 31 | 88 |
| 2022 November | 75 | 40 | 115 |
| 2022 October | 69 | 36 | 105 |
| 2022 September | 36 | 30 | 66 |
| 2022 August | 51 | 39 | 90 |
| 2022 July | 46 | 47 | 93 |
| 2022 June | 33 | 36 | 69 |
| 2022 May | 40 | 45 | 85 |
| 2022 April | 39 | 34 | 73 |
| 2022 March | 36 | 36 | 72 |
| 2022 February | 40 | 36 | 76 |
| 2022 January | 39 | 33 | 72 |
| 2021 December | 32 | 49 | 81 |
| 2021 November | 37 | 31 | 68 |
| 2021 October | 50 | 45 | 95 |
| 2021 September | 43 | 33 | 76 |
| 2021 August | 51 | 23 | 74 |
| 2021 July | 38 | 18 | 56 |
| 2021 June | 35 | 25 | 60 |
| 2021 May | 37 | 18 | 55 |
| 2021 April | 81 | 66 | 147 |
| 2021 March | 68 | 27 | 95 |
| 2021 February | 63 | 19 | 82 |
| 2021 January | 45 | 23 | 68 |
| 2020 December | 46 | 17 | 63 |
| 2020 November | 62 | 18 | 80 |
| 2020 October | 66 | 25 | 91 |
| 2020 September | 66 | 27 | 93 |
| 2020 August | 128 | 24 | 152 |
| 2020 July | 125 | 19 | 144 |
| 2020 June | 84 | 15 | 99 |
| 2020 May | 101 | 20 | 121 |
| 2020 April | 82 | 17 | 99 |
| 2020 March | 91 | 44 | 135 |
| 2020 February | 100 | 36 | 136 |
| 2020 January | 119 | 16 | 135 |
| 2019 December | 72 | 20 | 92 |
| 2019 November | 66 | 25 | 91 |
| 2019 October | 64 | 644 | 708 |
| 2019 September | 76 | 21 | 97 |
| 2019 August | 147 | 21 | 168 |
| 2019 July | 123 | 27 | 150 |
| 2019 June | 136 | 31 | 167 |
| 2019 May | 148 | 24 | 172 |
| 2019 April | 101 | 21 | 122 |
| 2019 March | 142 | 21 | 163 |
| 2019 February | 93 | 10 | 103 |
| 2019 January | 117 | 33 | 150 |
| 2018 December | 68 | 7 | 75 |
| 2018 November | 26 | 1 | 27 |
| 2018 October | 29 | 8 | 37 |
| 2018 September | 22 | 9 | 31 |
| 2018 August | 29 | 22 | 51 |
| 2018 July | 35 | 18 | 53 |
| 2018 June | 33 | 15 | 48 |
| 2018 May | 48 | 20 | 68 |
| 2018 April | 89 | 25 | 114 |
| 2018 March | 75 | 18 | 93 |
| 2018 February | 69 | 12 | 81 |
| 2018 January | 59 | 12 | 71 |
| 2017 December | 101 | 14 | 115 |
| 2017 November | 36 | 13 | 49 |
| 2017 October | 11 | 14 | 25 |
| 2017 September | 23 | 19 | 42 |
| 2017 August | 21 | 24 | 45 |
| 2017 July | 17 | 8 | 25 |
| 2017 June | 27 | 15 | 42 |
| 2017 May | 20 | 11 | 31 |
| 2017 April | 7 | 1 | 8 |
| 2017 March | 14 | 6 | 20 |
| 2017 February | 4 | 4 | 8 |
| 2017 January | 6 | 7 | 13 |
| 2016 December | 8 | 2 | 10 |
| 2016 November | 6 | 3 | 9 |
| 2016 October | 4 | 1 | 5 |
| 2016 September | 3 | 0 | 3 |
| 2016 August | 6 | 5 | 11 |
| 2016 July | 5 | 13 | 18 |
| 2016 June | 4 | 0 | 4 |
| 2016 May | 0 | 15 | 15 |
| 2016 April | 25 | 1 | 26 |
| 2016 March | 33 | 16 | 49 |
| 2016 February | 29 | 19 | 48 |
| 2016 January | 29 | 12 | 41 |
| 2015 December | 33 | 18 | 51 |
| 2015 November | 27 | 9 | 36 |
| 2015 October | 27 | 12 | 39 |
| 2015 September | 32 | 11 | 43 |
| 2015 August | 42 | 11 | 53 |
| 2015 July | 35 | 6 | 41 |
| 2015 June | 36 | 14 | 50 |
| 2015 May | 52 | 18 | 70 |
| 2015 April | 138 | 68 | 206 |
| 2015 March | 116 | 72 | 188 |
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