School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Sleep Breath. 2012 Sep;16(3):629-37. doi: 10.1007/s11325-011-0549-2. Epub 2011 Jun 27.
The study aimed to evaluate whether the inflammatory marker "high-sensitivity C-reactive protein (hsCRP)" level was associated with impaired heart rate recovery at 1 min after exercise termination (HRR-1) in middle-aged patients with severe obstructive sleep apnea (OSA).
Thirty middle-aged male patients (40-64 years old) with severe OSA (apnea-hypopnea index [AHI] ≥ 30 h(-1)) and 30 subjects without OSA (AHI < 5 h(-1)), matched with age and body mass index (BMI), were recruited. All subjects underwent an overnight polysomnography and completed a symptom-limited maximal exercise test. Cardiopulmonary parameters included peak oxygen consumption (VO(2peak)) and heart rate response during and immediately after exercise. Fasting blood samples were drawn for hsCRP analysis.
Patients with severe OSA had significantly higher hsCRP levels (0.18 vs. 0.07 mg/dl, P < 0.01), lower reduced HRR-1, peak heart rate, and VO(2peak) values than those in the controls. The hsCRP levels significantly correlated with HRR-1 in the OSA group (r = -0.69, P < 0.01) after adjustment for VO(2peak) (r = -0.66, P < 0.01). Furthermore, stepwise multiple regression analysis showed that HRR-1 and AHI were significant predictors of hsCRP levels in all participants (adjusted R(2) = 0.53, P < 0.01).
Blunted HRR was shown in middle-aged men with severe OSA, and it was associated with high hsCRP levels significantly.
研究旨在评估炎症标志物“高敏 C 反应蛋白（hsCRP）”水平是否与中年重度阻塞性睡眠呼吸暂停（OSA）患者运动终止后 1 分钟时的心率恢复受损（HRR-1）有关。
招募了 30 名中年男性重度 OSA（呼吸暂停低通气指数 [AHI]≥30 次/小时）患者和 30 名无 OSA（AHI<5 次/小时）患者，匹配年龄和体重指数（BMI）。所有患者均接受过夜多导睡眠图检查和症状限制最大运动测试。心肺参数包括最大摄氧量（VO2peak）和运动过程中和运动后即刻的心率反应。抽取空腹血样进行 hsCRP 分析。
重度 OSA 患者的 hsCRP 水平显著升高（0.18 比 0.07mg/dl，P<0.01），HRR-1、峰值心率和 VO2peak 值显著降低。在校正 VO2peak 后，hsCRP 水平与 OSA 组的 HRR-1 显著相关（r=-0.69，P<0.01）（r=-0.66，P<0.01）。此外，逐步多元回归分析显示，在所有参与者中，HRR-1 和 AHI 是 hsCRP 水平的显著预测因素（调整后的 R2=0.53，P<0.01）。
中年男性重度 OSA 患者存在 HRR 受损，与 hsCRP 水平显著相关。
