Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Eur Arch Otorhinolaryngol. 2013 Feb;270(2):749-54. doi: 10.1007/s00405-012-2191-4. Epub 2012 Sep 28.
Sleep-disordered breathing (SDB) such as snoring or obstructive sleep apnea and metabolic syndrome are both related to cardiovascular diseases. Being a surrogate marker of high risk for cardiovascular disorder, the high-sensitivity C-reactive protein (hs-CRP) level is thought to be elevated in patients with both SDB and metabolic syndrome. To understand better the development of cardiovascular disease in patients with SDB, we examined the association of metabolic variables with hs-CRP levels in adult patients with symptoms of SDB and without any previous treatment, who were selected to participate in the study. Metabolic parameters including fasting blood glucose, lipid profile and hs-CRP were measured following an overnight polysomnography. Laboratory and polysomnographic data were analyzed to identify variables related to high hs-CRP levels. A total of 309 patients with SDB participated in this study. Of these, 139 presented with hs-CRP <1 mg/L and 52 presented with hs-CRP >3 mg/L. Patients with high hs-CRP showed a higher apnea-hypopnea index (AHI), body mass index (BMI), fasting glucose, and triglyceride level, and a lower mean and minimal oxygen saturation and HDL-cholesterol level. However, ordinal regression analysis demonstrated that only a higher BMI and fasting glucose level and a lower HDL-cholesterol level were independent risk factors for cardiovascular diseases (OR = 1.076, 95 % CI = 1.009-1.147, p = 0.005; OR = 1.011, 95 % CI = 1.004-1.019, p = 0.008; OR = 0.966, 95 % CI = 0.947-0.984, p < 0.001, respectively). The results showed that elevated hs-CRP is common in patients with SDB but is not independently associated with the severity of SDB. Metabolic factors such as a higher BMI and fasting blood glucose and a lower HDL-cholesterol level were more strongly associated with elevated hs-CRP rather than with SDB severity, suggesting that metabolic parameters are important contributors to cardiovascular diseases and should be corrected in patients with SDB.
睡眠呼吸障碍（SDB），如打鼾或阻塞性睡眠呼吸暂停和代谢综合征，都与心血管疾病有关。高敏 C 反应蛋白（hs-CRP）被认为是心血管疾病高危的替代标志物，在患有 SDB 和代谢综合征的患者中，hs-CRP 水平升高。为了更好地了解 SDB 患者心血管疾病的发展，我们检查了代谢变量与未经任何治疗的 SDB 症状成年患者 hs-CRP 水平之间的相关性，这些患者被选择参加这项研究。在一夜的多导睡眠图检查后，测量了代谢参数，包括空腹血糖、血脂谱和 hs-CRP。分析实验室和多导睡眠图数据，以确定与高 hs-CRP 水平相关的变量。共有 309 名 SDB 患者参加了这项研究。其中 139 人 hs-CRP<1mg/L，52 人 hs-CRP>3mg/L。hs-CRP 较高的患者 AHI、BMI、空腹血糖和甘油三酯水平较高，平均和最小氧饱和度和 HDL 胆固醇水平较低。然而，有序回归分析表明，只有更高的 BMI 和空腹血糖水平以及更低的 HDL 胆固醇水平是心血管疾病的独立危险因素（OR=1.076，95%CI=1.009-1.147，p=0.005；OR=1.011，95%CI=1.004-1.019，p=0.008；OR=0.966，95%CI=0.947-0.984，p<0.001）。结果表明，SDB 患者 hs-CRP 升高很常见，但与 SDB 严重程度无关。代谢因素，如较高的 BMI 和空腹血糖水平以及较低的 HDL 胆固醇水平，与 hs-CRP 升高的相关性更强，而不是与 SDB 严重程度相关，这表明代谢参数是心血管疾病的重要因素，应该在 SDB 患者中纠正。
