Minoguchi K, Yokoe T, Tanaka A, Ohta S, Hirano T, Yoshino G, O'Donnell C P, Adachi M
First Dept of Internal Medicine, Showa University, School of Medicine, 1-5-8 Hatanodai, Tokyo 142-8666, Japan.
Eur Respir J. 2006 Aug;28(2):378-85. doi: 10.1183/09031936.06.00084905.
In the present study, the authors examined the relationship between lipid peroxidation and inflammation in patients with obstructive sleep apnoea (OSA). A total of 40 obese patients with OSA were studied, along with 18 obese and 12 lean subjects without OSA. Overnight excretion of 8-isoprostane in urine and serum levels of high-sensitivity C-reactive protein (hsCRP) were measured. In addition, the effects of 3 months' treatment with nasal continuous positive airway pressure (nCPAP) were studied in 20 obese patients with moderate-to-severe OSA. Overnight urinary excretion of 8-isoprostane and serum levels of hsCRP were significantly higher in patients with moderate-to-severe OSA compared with patients with mild OSA and obese or lean subjects without OSA. Overnight urinary excretion of 8-isoprostane significantly correlated with apnoea-hypopnoea index, duration of hypoxia during sleep, body mass index, and serum levels of hsCRP in patients with OSA. The severity of OSA was an independent factor predicting the urinary excretion of 8-isoprostane. nCPAP significantly decreased urinary excretion of 8-isoprostane and serum levels of hsCRP. In conclusion, these results suggest that both obstructive sleep apnoea severity and obesity can independently contribute to elevations in urinary excretion of 8-isoprostane. Therefore, obstructive sleep apnoea may increase the risks of cardiovascular morbidity in obese patients.
在本研究中，作者探讨了阻塞性睡眠呼吸暂停（OSA）患者脂质过氧化与炎症之间的关系。共研究了40例肥胖的OSA患者，以及18例肥胖且无OSA的受试者和12例体重正常且无OSA的受试者。检测了尿中8-异前列腺素的夜间排泄量以及血清高敏C反应蛋白（hsCRP）水平。此外，还对20例中重度OSA肥胖患者进行了为期3个月的经鼻持续气道正压通气（nCPAP）治疗效果研究。与轻度OSA患者以及肥胖或体重正常的无OSA受试者相比，中重度OSA患者的8-异前列腺素夜间尿排泄量和hsCRP血清水平显著更高。OSA患者的8-异前列腺素夜间尿排泄量与呼吸暂停低通气指数、睡眠期间缺氧持续时间、体重指数以及hsCRP血清水平显著相关。OSA的严重程度是预测8-异前列腺素尿排泄量的独立因素。nCPAP显著降低了8-异前列腺素的尿排泄量和hsCRP血清水平。总之，这些结果表明，阻塞性睡眠呼吸暂停的严重程度和肥胖均可独立导致8-异前列腺素尿排泄量升高。因此，阻塞性睡眠呼吸暂停可能会增加肥胖患者发生心血管疾病的风险。
