Shiina Kazuki, Tomiyama Hirofumi, Takata Yoshifumi, Usui Yasuhiro, Asano Kihiro, Hirayama Yoji, Nakamura Takeshi, Yamashina Akira
Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
Hypertens Res. 2006 Jun;29(6):433-41. doi: 10.1291/hypres.29.433.
This cross-sectional study was conducted to examine whether the obstructive sleep apnea syndrome (OSAS) is associated with elevation of the pulse wave velocity (PWV) and increase in the plasma levels of C-reactive protein (CRP), both of which are known markers of cardiovascular risk, and also to determine if the concurrent presence of the metabolic syndrome might exacerbate this elevation in the levels of these cardiovascular risk markers in subjects with OSAS. With these objectives, the PWV and serum CRP were measured in 184 subjects attending a sleep clinic. It was found that the PWV and CRP were higher in the subjects with OSAS (n=94) than in those without OSAS (n=90). Furthermore, among the subjects with OSAS, the PWV and CRP were higher in those with the concurrent presence of the metabolic syndrome (n= 41; PWV=1,562+/-19 cm/s; CRP=1.8+/-0.2 mg/l) than in those without metabolic syndrome (n=53; PWV=1,432+/-21 cm/s; CRP=1.2+/-0.1 mg/l) (p<0.05). A general linear model analysis demonstrated that OSAS and metabolic syndrome were independently associated with elevated PWV and increase of the plasma levels of CRP. OSAS appears to be associated with increased cardiovascular risk, as reflected by both elevated PWV and increase of the plasma CRP. The concurrent presence of metabolic syndrome may exacerbate this increase in cardiovascular risk in subjects with OSAS. Therefore, the concurrent presence of metabolic syndrome may constitute an additive cardiovascular risk factor in subjects with OSAS.
本横断面研究旨在探讨阻塞性睡眠呼吸暂停综合征（OSAS）是否与脉搏波速度（PWV）升高及血浆C反应蛋白（CRP）水平增加相关，这两者均为已知的心血管风险标志物，同时确定代谢综合征的并存是否会加剧OSAS患者这些心血管风险标志物水平的升高。基于这些目标，对184名就诊于睡眠诊所的受试者进行了PWV和血清CRP测量。结果发现，OSAS患者（n = 94）的PWV和CRP高于无OSAS患者（n = 90）。此外，在OSAS患者中，并存代谢综合征者（n = 41；PWV = 1562±19 cm/s；CRP = 1.8±0.2 mg/l）的PWV和CRP高于无代谢综合征者（n = 53；PWV = 1432±21 cm/s；CRP = 1.2±0.1 mg/l）（p<0.05）。一般线性模型分析表明，OSAS和代谢综合征分别与PWV升高及血浆CRP水平增加独立相关。OSAS似乎与心血管风险增加相关，表现为PWV升高和血浆CRP增加。代谢综合征的并存可能会加剧OSAS患者心血管风险的增加。因此，代谢综合征的并存可能是OSAS患者心血管风险的一个附加因素。
