Sasanabe Ryujiro, Banno Katsuhisa, Otake Kazuo, Hasegawa Rika, Usui Kengo, Morita Mikiko, Shiomi Toshiaki
Sleep Disorders Center, Aichi Medical University Hospital, Japan.
Hypertens Res. 2006 May;29(5):315-22. doi: 10.1291/hypres.29.315.
We investigated the prevalence of metabolic syndrome in patients with obstructive sleep apnea syndrome (OSAS) referred to a tertiary university-based medical center. A cross-sectional study of patients with a definite diagnosis of OSAS was performed using new diagnostic criteria for metabolic syndrome that were designed for the Japanese population. Clinical features and comorbidities related to metabolic syndrome were compared between 819 patients with OSAS (719 men and 100 women) and 89 control subjects without OSAS. Metabolic syndrome was significantly more common in the patients with OSAS than in the controls (49.5% vs. 22.0% for men, p < 0.01; 32.0% vs. 6.7% for women, p < 0.01). Men with OSAS (apnea-hypopnea index [AHI] > or =5/h) had a higher risk of metabolic syndrome compared with controls (odds ratio [OR]: 3.47; 95% confidence interval [CI]: 1.84-6.53). There was a significantly increased risk of metabolic syndrome in men with moderate OSAS (AHI: 15-29.9/h) (OR: 2.83; 95% CI: 1.42-5.66) and men with severe OSAS (AHI > or =30/h) (OR: 5.09; 95% CI: 2.67-9.71). Women with OSAS (AHI> or =5/h) also had an increased risk of metabolic syndrome (OR: 6.59; 95% CI: 1.47-29.38), and the risk was significantly higher in women with severe OSAS (AHI > or =30/h) (OR 14.00; 95% CI: 2.93-66.82). Risk factors for metabolic syndrome differed by gender: in men, age, body mass index (BMI), and OSAS (AHI > or =15/h) were significantly associated with metabolic syndrome, whereas, in women, BMI was the only risk factor for metabolic syndrome. The increase of metabolic syndrome in Japanese OSAS patients suggests that this patient population is burdened with multiple risk factors for cardiovascular disease.
我们对一所大学附属三级医疗中心收治的阻塞性睡眠呼吸暂停综合征（OSAS）患者的代谢综合征患病率进行了调查。采用针对日本人群设计的代谢综合征新诊断标准，对确诊为OSAS的患者进行了横断面研究。比较了819例OSAS患者（719例男性和100例女性）和89例无OSAS的对照者与代谢综合征相关的临床特征和合并症。OSAS患者中代谢综合征的发生率显著高于对照组（男性为49.5%对22.0%，p<0.01；女性为32.0%对6.7%，p<0.01）。与对照组相比，患有OSAS（呼吸暂停低通气指数[AHI]≥5次/小时）的男性患代谢综合征的风险更高（比值比[OR]：3.47；95%置信区间[CI]：1.84 - 6.53）。中度OSAS（AHI：15 - 29.9次/小时）的男性（OR：2.83；95%CI：1.42 - 5.66）和重度OSAS（AHI≥30次/小时）的男性（OR：5.09；95%CI：2.67 - 9.71）患代谢综合征的风险显著增加。患有OSAS（AHI≥5次/小时）的女性患代谢综合征的风险也增加（OR：6.59；95%CI：1.47 - 29.38），重度OSAS（AHI≥30次/小时）的女性风险显著更高（OR 14.00；95%CI：2.93 - 66.82）。代谢综合征的危险因素因性别而异：在男性中，年龄、体重指数（BMI）和OSAS（AHI≥15次/小时）与代谢综合征显著相关，而在女性中，BMI是代谢综合征的唯一危险因素。日本OSAS患者中代谢综合征的增加表明，这一患者群体负担着多种心血管疾病危险因素。
