Department of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA.
Department of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA.
Chest. 2012 Jul;142(1):239-245. doi: 10.1378/chest.11-2322.
Obstructive sleep apnea (OSA) is a condition of repetitive upper airway collapse, which occurs during sleep. Recent literature has emphasized the role of OSA in contributing to glucose intolerance, dyslipidemia, and hypertension. OSA is associated with the development of cardiovascular disease, although definitive data are sparse with regard to the prevention of cardiovascular disease and CPAP therapy. CPAP provides effective treatment for OSA, but patient adherence remains challenging. Aside from daytime symptom improvement, it is difficult to monitor the adequacy of treatment response. Thus, the search for a biomarker becomes critical. The discovery of an ideal biomarker for OSA has the potential to provide information related to diagnosis, severity, prognosis, and response to treatment. In addition, because large-scale randomized controlled trials are both ethically and logistically challenging in assessing hard cardiovascular outcomes, certain biomarkers may be reasonable surrogate outcome measures. This article reviews the literature related to potential biomarkers of OSA with the recognition that an ideal biomarker does not exist at this time.
阻塞性睡眠呼吸暂停(OSA)是一种上呼吸道反复塌陷的疾病,发生在睡眠期间。最近的文献强调了 OSA 在导致葡萄糖耐量异常、血脂异常和高血压方面的作用。OSA 与心血管疾病的发展有关,尽管关于心血管疾病的预防和 CPAP 治疗的明确数据仍然很少。CPAP 为 OSA 提供了有效的治疗,但患者的依从性仍然是一个挑战。除了白天症状的改善,很难监测治疗反应的充分性。因此,寻找生物标志物变得至关重要。发现一种理想的 OSA 生物标志物有可能提供与诊断、严重程度、预后和治疗反应相关的信息。此外,由于在评估硬心血管结局方面,大型随机对照试验在伦理和后勤方面都具有挑战性,因此某些生物标志物可能是合理的替代结局指标。本文回顾了与 OSA 潜在生物标志物相关的文献,认识到目前还没有理想的生物标志物。