Blomster Henry, Laitinen Tomi, Lyyra-Laitinen Tiina, Vanninen Esko, Gylling Helena, Peltonen Markku, Martikainen Tarja, Sahlman Johanna, Kokkarinen Jouko, Randell Jukka, Smirnov Grigori, Seppä Juha, Tuomilehto Henri
Institute of Clinical Medicine, Department of Otorhinolaryngology, Kuopio University Hospital, and University of Eastern Finland, P.O. Box 1777, 70211, Kuopio, Finland,
Sleep Breath. 2014 Mar;18(1):177-86. doi: 10.1007/s11325-013-0867-7. Epub 2013 Jun 4.
Endothelial dysfunction is one of the early markers of cardiovascular complications in obstructive sleep apnea (OSA). The aim of our study was to evaluate whether overweight patients with mild OSA displayed endothelial dysfunction, and to assess the effect of 1-year lifestyle intervention with an early very low calorie diet in endothelial function.
At baseline, the study population consisted of 83 overweight patients with mild OSA and 46 weight-matched non-OSA subjects. OSA patients were further randomized into a 1-year supervised lifestyle intervention group or control group which received routine lifestyle counselling. Endothelial function measured by brachial artery flow-mediated dilatation (FMD), apnea-hypopnea index (AHI), body mass index (BMI), and metabolic parameters were assessed at baseline and 12 months.
No correlations between endothelial function and mild OSA were detected. However, patients with impaired endothelial function had lower mean saturation and impaired endothelial function correlated significantly with glucose intolerance and dyslipidemia. After the lifestyle intervention and successful weight reduction, AHI, BMI, serum triglycerides and insulin improved significantly; however, no improvement in FMD was detected.
Mild OSA was not observed to be associated with endothelial dysfunction. Although in mild OSA endothelial function is still preserved, lifestyle intervention with weight reduction did achieve an improvement in other obesity-related risk factors for cardiovascular diseases, thus highlighting the importance of early intervention.
内皮功能障碍是阻塞性睡眠呼吸暂停（OSA）心血管并发症的早期标志物之一。我们研究的目的是评估轻度OSA超重患者是否存在内皮功能障碍，并评估早期极低热量饮食的1年生活方式干预对内皮功能的影响。
在基线时，研究人群包括83例轻度OSA超重患者和46例体重匹配的非OSA受试者。OSA患者被进一步随机分为1年的监督生活方式干预组或接受常规生活方式咨询的对照组。在基线和12个月时评估通过肱动脉血流介导的扩张（FMD）测量的内皮功能、呼吸暂停低通气指数（AHI）、体重指数（BMI）和代谢参数。
未检测到内皮功能与轻度OSA之间的相关性。然而，内皮功能受损的患者平均血氧饱和度较低，且内皮功能受损与葡萄糖不耐受和血脂异常显著相关。生活方式干预和成功减重后，AHI、BMI、血清甘油三酯和胰岛素显著改善；然而，未检测到FMD有改善。
未观察到轻度OSA与内皮功能障碍相关。尽管在轻度OSA中内皮功能仍得以保留，但减重的生活方式干预确实改善了其他与肥胖相关的心血管疾病危险因素，从而突出了早期干预的重要性。
