Cardiology Discipline, Medicine Department, Universidade Federal de São Paulo, São Paulo, Brazil.
Chest. 2010 Jan;137(1):109-14. doi: 10.1378/chest.09-1201. Epub 2009 Oct 3.
Conflicting data regarding exercise capacity and obstructive sleep apnea (OSA) have been published, which may be partially explained by the difficulty of controlling all of the confounding factors. The aim of this study is to evaluate the exercise, anthropometric, and blood parameters in lean, sedentary patients with OSA compared with controls.
Fifty-four lean subjects (including 27 patients with OSA and 27 controls) were selected. The control group was matched for age and gender. All subjects underwent polysomnography, anthropometric measures, a cardiorespiratory exercise test, two-dimensional transthoracic echocardiography, and spirometry.
The mean age was 52.9 +/- 7.9 years in subjects with OSA and 52.8 +/- 8.1 years in controls (P = .95). The cervical circumference was greater in the lean OSA group when compared with the controls (33.7 +/- 3.5 cm vs 31.4 +/- 2.8 cm; P = .01). There were statistical differences in the apnea-hypopnea index, minimal oxygen saturation, and mean oxygen saturation in the lean patients with OSA. Glycemia was higher in the lean OSA group (115.1 +/- 50.1 mg/dL vs 94.2 +/- 9.8 mg/dL; P = .04). There were no differences between groups in the peak oxygen consumption (Vo(2)), anaerobic threshold (AT), respiratory exchange ratio (RER), BP, and heart rate.
High glycemia and cervical circumference enlargement are the main characteristics of lean patients with OSA. Exercise performance is similar between groups, considering the peak Vo(2), AT, and RER. These results suggest that OSA does not impair functional capacity in lean subjects and that obesity probably participates in the diminished cardiopulmonary capacity observed in patients with OSA.
关于运动能力和阻塞性睡眠呼吸暂停（OSA）的数据相互矛盾，这可能部分是由于难以控制所有混杂因素所致。本研究的目的是评估与对照组相比，瘦型、久坐的 OSA 患者的运动、人体测量和血液参数。
选择了 54 名瘦型受试者（包括 27 名 OSA 患者和 27 名对照组）。对照组按年龄和性别匹配。所有受试者均进行了多导睡眠图、人体测量、心肺运动试验、二维经胸超声心动图和肺功能检查。
OSA 组受试者的平均年龄为 52.9 ± 7.9 岁，对照组为 52.8 ± 8.1 岁（P =.95）。与对照组相比，瘦型 OSA 组的颈围更大（33.7 ± 3.5 cm 比 31.4 ± 2.8 cm；P =.01）。瘦型 OSA 患者的睡眠呼吸暂停低通气指数、最小氧饱和度和平均氧饱和度存在统计学差异。瘦型 OSA 组的血糖水平更高（115.1 ± 50.1 mg/dL 比 94.2 ± 9.8 mg/dL；P =.04）。两组之间的峰值摄氧量（Vo2）、无氧阈（AT）、呼吸交换率（RER）、血压和心率无差异。
高血糖和颈围增大是瘦型 OSA 患者的主要特征。考虑到峰值 Vo2、AT 和 RER，两组之间的运动能力相似。这些结果表明，OSA 不会损害瘦型患者的心肺功能，肥胖可能参与了 OSA 患者心肺功能下降的过程。
