Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
Am J Cardiol. 2011 Nov 1;108(9):1266-71. doi: 10.1016/j.amjcard.2011.06.042. Epub 2011 Aug 15.
Acute coronary syndrome (ACS) during sleep occurs at a relatively low frequency and the pathogenic background remains uncertain. The aim of the present study was to determine the significance of sleep-disordered breathing (SDB) and excess visceral fat with nocturnal dysregulation of adipocytokines in night-time onset of ACS. SDB, visceral fat area (VFA), and changes in circulating adipocytokine levels were assessed in 109 consecutive patients with ACS. SDB and VFA were assessed by cardiorespiratory monitoring and computed tomographic scan, respectively. Visceral fat accumulation was more common in patients with (12 to 7 a.m.) than without (7 to 12 a.m.) night-time onset of ACS (p <0.05). In patients with night-time onset of ACS, those with excess visceral fat were significantly more likely to have SDB and nocturnal dysregulation of adiponectin than those without such accumulation (p <0.05), but there was no difference between those with and without excess visceral fat (VFA cutoff 100 cm(2)) in patients with non-night-time onset of ACS. In conclusion, night-time onset of ACS is associated with excess visceral fat and SDB (referred as to "syndrome Z"). SDB and excess visceral fat are treatable risk factors. Decrease of excess visceral fat and treatment of SDB could be beneficial in in preventing nocturnal cardiac events.
睡眠期间发生的急性冠状动脉综合征（ACS）频率相对较低，其发病机制仍不清楚。本研究旨在确定睡眠呼吸紊乱（SDB）和过多内脏脂肪与夜间脂肪细胞因子失调在 ACS 夜间发作中的意义。对 109 例连续 ACS 患者进行了睡眠呼吸紊乱、内脏脂肪面积（VFA）和循环脂肪细胞因子水平变化的评估。通过心肺监测和计算机断层扫描评估 SDB 和 VFA。与（7 点至次日 12 点）相比，ACS 夜间发作患者（12 点至次日 7 点）内脏脂肪堆积更为常见（p<0.05）。在 ACS 夜间发作的患者中，与没有这种堆积的患者相比，内脏脂肪过多的患者更有可能发生 SDB 和夜间脂联素失调（p<0.05），但在没有夜间发作的 ACS 患者中，内脏脂肪过多（VFA 截止值为 100cm²）的患者之间没有差异。总之，ACS 的夜间发作与内脏脂肪过多和 SDB（称为“Z 综合征”）有关。SDB 和内脏脂肪过多是可治疗的危险因素。减少内脏脂肪过多和治疗 SDB 可能有助于预防夜间心脏事件。
