Department of Pulmonary Diseases, Faculty of Medicine, Maltepe University, Istanbul, Turkey.
Respiration. 2010;79(1):38-45. doi: 10.1159/000210429. Epub 2009 Mar 31.
The obstructive sleep apnea syndrome (OSAS) is characterized by repeated upper airway obstruction during sleep together with decreases in oxygen saturation leading to a series of pathological events, primarily in the cardiovascular system. Elevated plasma homocysteine levels have recently been considered as an independent risk factor for vascular disease, and increased levels are attributed to cardiovascular diseases.
We aimed to investigate the possible relationship between homocysteine levels and echocardiographic findings in OSAS patients at different stages of disease.
Thirty-eight patients (23 males and 15 females) with polysomnographically verified OSAS (mean age, 49 +/- 12 years, range 27-74) and a mean body mass index of 31.27 +/- 5.24 kg/m(2) (range 22.60-47.90) were prospectively studied. Plasma levels of homocysteine, cholesterols, triglycerides, vitamin B(12) and high-sensitive C-reactive protein (hsCRP), as well as echocardiographic and lung function parameters were assessed.
Homocysteine levels were elevated in all OSAS groups and were statistically significantly different between the mild and moderate/severe groups. Significant differences were present between the variables nocturnal oxygen desaturation (NOD), respiratory arousal and light sleep among the mild and moderate/severe groups. We found a significant positive correlation between homocysteine levels and NOD duration, and hsCRP levels were positively correlated with the apnea-hypopnea index and NOD duration.
In all OSAS groups, homocysteine levels were elevated regardless of the presence of cardiac dysfunction. Echocardiographic abnormalities were primarily left-ventricular (LV) hypertrophy and LV diastolic dysfunction and could be observed in all OSAS severity groups.
阻塞性睡眠呼吸暂停综合征（OSAS）的特征是睡眠期间反复发生上气道阻塞，同时伴有氧饱和度降低，导致一系列病理事件，主要发生在心血管系统。最近，血浆同型半胱氨酸水平升高被认为是血管疾病的独立危险因素，并且升高归因于心血管疾病。
我们旨在研究不同疾病阶段的 OSAS 患者的同型半胱氨酸水平与超声心动图结果之间可能存在的关系。
我们前瞻性研究了 38 名经多导睡眠图证实的 OSAS 患者（23 名男性和 15 名女性；平均年龄 49 ± 12 岁，范围 27-74 岁；平均体重指数为 31.27 ± 5.24 kg/m2，范围 22.60-47.90）。评估了血浆同型半胱氨酸、胆固醇、甘油三酯、维生素 B12 和高敏 C 反应蛋白（hsCRP）水平以及超声心动图和肺功能参数。
所有 OSAS 组的同型半胱氨酸水平均升高，且轻度和中重度/重度组之间存在统计学差异。在轻度和中重度/重度组之间，变量夜间氧饱和度下降（NOD）、呼吸觉醒和浅睡眠之间存在显著差异。我们发现同型半胱氨酸水平与 NOD 持续时间之间存在显著正相关，hsCRP 水平与呼吸暂停-低通气指数和 NOD 持续时间之间存在正相关。
在所有 OSAS 组中，同型半胱氨酸水平升高，无论是否存在心功能障碍。超声心动图异常主要为左心室（LV）肥厚和 LV 舒张功能障碍，并且可以在所有 OSAS 严重程度组中观察到。
