Institute of Human Genomic Study, School of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
Sleep. 2013 May 1;36(5):709-715B. doi: 10.5665/sleep.2632.
Obstructive sleep apnea (OSA) contributes to the development of systemic hypertension, and hypertension strongly predicts the development of white matter change (WMC). Thus, it is plausible that OSA mediates WMC. The goal of the current study is to determine whether a contextual relationship exists between OSA and cerebral WMC.
Cross-sectional analyses conducted in a population-based study.
Korean community-based sample from the Korean Genome and Epidemiology Study (KoGES) who attended examinations in 2011 at a medical center.
There were 503 individuals (mean ± SD, age 59.63 ± 7.48 y) who were free of previously diagnosed cardiovascular and neurologic diseases.
Participants underwent 1-night polysomnography and were classified as no OSA (obstructive apnea-hypopnea index [AHI] < 5, n = 289), mild OSA (AHI 5-15, n = 161), and moderate to severe OSA (AHI ≥ 15, n = 53). WMC was identified with brain magnetic resonance imaging (MRI) and was found in 199 individuals (39.56%). Multivariate logistic regression analyses adjusted for covariates revealed that moderate to severe OSA was significantly associated with the presence of WMC (odds ratio [OR] 2.08, 95%, confidence interval [CI] 1.05-4.13) compared with no OSA. Additional adjustment of hypertension to the model did not alter the significance of the association (OR 2.03, 95% CI 1.02-4.05).
Moderate to severe OSA is an independent risk factor for WMC in middle-aged and older individuals. Thus, early recognition and treatment of OSA could reduce the risk of stroke and vascular dementia.
阻塞性睡眠呼吸暂停（OSA）可导致全身性高血压的发生，而高血压强烈预示着脑白质改变（WMC）的发生。因此，OSA 可能是 WMC 的中介因素。本研究的目的是确定 OSA 与大脑 WMC 之间是否存在相关性。
在一项基于人群的研究中进行的横断面分析。
参加韩国全基因组和流行病学研究（KoGES）的韩国社区样本，他们于 2011 年在一家医疗中心接受了检查。
共有 503 名个体（平均年龄±标准差，59.63±7.48 岁），他们没有先前诊断的心血管和神经系统疾病。
参与者接受了 1 晚的多导睡眠图检查，并根据阻塞性呼吸暂停低通气指数（AHI）分为无 OSA（AHI<5，n=289）、轻度 OSA（AHI 5-15，n=161）和中重度 OSA（AHI≥15，n=53）。脑磁共振成像（MRI）确定了 WMC，发现有 199 名个体（39.56%）存在 WMC。经过多变量逻辑回归分析，调整了协变量后，中重度 OSA 与 WMC 的发生显著相关（比值比[OR]2.08，95%置信区间[CI]1.05-4.13），与无 OSA 相比。将高血压纳入模型进行进一步调整并未改变该关联的显著性（OR 2.03，95%CI 1.02-4.05）。
中重度 OSA 是中老年人 WMC 的独立危险因素。因此，早期识别和治疗 OSA 可以降低中风和血管性痴呆的风险。
