Department of Community Medicine and School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong.
Respir Med. 2010 Nov;104(11):1750-6. doi: 10.1016/j.rmed.2010.06.003. Epub 2010 Jun 27.
abitual snoring and elevated high-sensitive C-reactive protein (HsCRP) have both been associated with increased risk of cardiovascular disease. However, snoring and HsCRP are elevated in obese states which may thus be the primary determinant of both. We therefore investigated whether snoring may mediate the increased vascular risk directly through increased inflammation as indicated by HsCRP levels or if other determinants predominated in a large older Chinese population.
A total of 2508 males and 5709 females aged 50-85 years received a medical check-up including measurement of blood pressure, obesity indices, fasting total, LDL-, HDL-cholesterol, triglycerides, glucose and HsCRP. Information on self-reported snoring status was collected by standardized interview.
The age-adjusted geometric mean HsCRP concentrations increased significantly with higher snoring frequency in both genders (linear trend, p=0.02 for men and p<0.001 for women), but the association was no longer significant after controlling for waist and BMI. Furthermore, HsCRP levels were not significantly associated with snoring frequency groups stratified by BMI/waist quintiles in both genders, except for the 4th waist quintile in men. No interaction was observed between snoring and BMI/waist on HsCRP levels. The multivariate analysis showed that, in both genders, obesity, but not HsCRP, was associated with snoring.
Our results showed that snoring frequency did not have an independent effect on inflammation after adjusting for adiposity, and may thus contribute to vascular disease through alternative mechanisms.
习惯性打鼾和高敏 C 反应蛋白（HsCRP）升高均与心血管疾病风险增加相关。然而，肥胖状态下会出现打鼾和 HsCRP 升高，因此这可能是两者的主要决定因素。因此，我们研究了在一个大型的中国老年人群中，打鼾是否可能通过 HsCRP 水平升高所指示的炎症增加直接导致血管风险增加，或者是否存在其他决定因素起主导作用。
共有 2508 名男性和 5709 名年龄在 50-85 岁的女性接受了体检，包括血压、肥胖指数、空腹总胆固醇、LDL-、HDL-胆固醇、甘油三酯、葡萄糖和 HsCRP 的测量。通过标准化访谈收集了关于自我报告的打鼾状况的信息。
在男女两性中，年龄调整后的 HsCRP 浓度随着打鼾频率的增加而显著升高（线性趋势，男性为 p=0.02，女性为 p<0.001），但在控制腰围和 BMI 后，这种关联不再显著。此外，在男女两性中，除了男性第 4 个腰围五分位组外，HsCRP 水平与根据 BMI/腰围五分位组分层的打鼾频率组之间没有显著相关性。在 HsCRP 水平方面，未观察到打鼾与 BMI/腰围之间的交互作用。多元分析显示，在男女两性中，肥胖而不是 HsCRP 与打鼾相关。
我们的研究结果表明，在调整肥胖后，打鼾频率对炎症没有独立影响，因此可能通过替代机制导致血管疾病。
