Ambrosetti Marco, Lucioni Anna Maria, Conti Simonetta, Pedretti Roberto F E, Neri Margherita
Division of Cardiology, Italy.
J Cardiovasc Med (Hagerstown). 2006 Nov;7(11):826-9. doi: 10.2459/01.JCM.0000250873.01649.41.
There is little evidence available about the relationship between metabolic syndrome as a comprehensive clinical entity and obstructive sleep apnea (OSA) with respect to the cardiovascular risk of patients with coexisting metabolic syndrome and OSA.
Eighty-nine consecutive patients (males 85%, aged 62 +/- 11 years) with newly-diagnosed OSA were evaluated for the presence of metabolic syndrome and the incidence of cardiovascular events after implementation of continuous positive airway pressure (CPAP) therapy was registered during medium-term follow-up. The diagnosis of OSA and metabolic syndrome was obtained by overnight polygraphy [with a presence of an apnea-hypopnea index (AHI) >or= 15] and following NCEP ATP III recommendations, respectively.
Forty-seven (53%) OSA patients had coexisting metabolic syndrome, with increased waist circumference (98%), high blood pressure (89%) and decreased high-density lipoprotein-cholesterol (83%) as the most frequent features. OSA patients with metabolic syndrome were also younger (58 +/- 11 years versus 65 +/- 4 years, P < 0.001) and presented an higher AHI (43.5 +/- 20.2 versus 34.8 +/- 17.3, P < 0.05) as compared to those without metabolic syndrome. Follow-up lasted 22 +/- 10 months. OSA patients who also presented metabolic syndrome suffered events less frequently compared to those who did not (6% versus 24%, P < 0.05), whereas the single end-points for follow-up (i.e. death, acute coronary syndrome, cerebrovascular event, peripheral vascular event, venous thromboembolism) did not significantly differ between the two groups.
Metabolic syndrome was a frequent comorbidity in OSA patients, reflecting higher degrees of sleep-disordered breathing, and did not increase the risk of cardiovascular events after adoption of CPAP therapy.
关于作为一种综合临床实体的代谢综合征与阻塞性睡眠呼吸暂停（OSA）之间的关系，就并存代谢综合征和OSA患者的心血管风险而言，现有证据很少。
对89例新诊断为OSA的连续患者（男性占85%，年龄62±11岁）进行代谢综合征评估，并在中期随访期间记录持续气道正压通气（CPAP）治疗实施后心血管事件的发生率。OSA和代谢综合征的诊断分别通过夜间多导睡眠图[呼吸暂停低通气指数（AHI）≥15]和遵循美国国家胆固醇教育计划成人治疗组第三次报告（NCEP ATP III）建议获得。
47例（53%）OSA患者并存代谢综合征，最常见的特征是腰围增加（98%）、高血压（89%）和高密度脂蛋白胆固醇降低（83%）。与无代谢综合征的OSA患者相比，并存代谢综合征的OSA患者年龄也更小（58±11岁对65±4岁，P<0.001），且AHI更高（43.5±20.2对34.8±17.3，P<0.05）。随访持续22±10个月。并存代谢综合征的OSA患者发生事件的频率低于未并存代谢综合征的患者（6%对24%，P<0.05），而两组随访的单一终点（即死亡、急性冠状动脉综合征、脑血管事件、外周血管事件、静脉血栓栓塞）无显著差异。
代谢综合征在OSA患者中是一种常见的合并症，反映了睡眠呼吸紊乱程度较高，并且在采用CPAP治疗后并未增加心血管事件的风险。
