Yedikule Chest Disease and Thoracic Surgery Education and Research Hospital, Sleep Laboratory, İstanbul, Turkey;
Department of Radiology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey;
J Thorac Dis. 2013 Dec;5(6):751-7. doi: 10.3978/j.issn.2072-1439.2013.11.25.
In the present study, we want to demonstrate the correlation between obstructive sleep apnea syndrome (OSAS) whose independent effect on carotid artery intima-media thickness (IMT) was demonstrated, with Framingham risk score (FRS) showing the overall cardiovascular risk.
IMT of the carotid artery was measured with ultrasonography and 10-year risk of coronary heart disease (CHD) was defined with FRS in 90 consecutive patients referred to our sleep clinic and who underwent polysomnography (PSG), with vascular risk factors and without a clinical atherosclerotic disease.
IMT and FRS were found to be statistically significantly increased in the severe OSAS group compared to the other two groups. Carotid IMT was found to be significantly positively correlated with, apnea-hypopnea index (AHI), oxygen desaturation index (ODI) and time duration with oxygen saturation (SpO2) <90%, and negatively correlated with minimum oxygen saturation at sleep (minimum SpO2) and mean SpO2. In control and mild OSAS group IMT and FRS have significantly positive correlation (r: 0.501, P: 0.027; r: 0.625, P<0.001), while in severe OSAS group no significant correlation was detected between IMT and FRS (r: 0.321, P: 0.06). In the regression analysis AHI and ODI were found to be an independent predictor of carotid IMT. ODI was found to have an independent effect on the progression of atherosclerosis.
Increased carotid IMT in severe OSAS group could not be explained with the classical risk factors. In this respect, FRS might be insufficient to determine correctly the cardiovascular risk and protection strategies against the disease in OSAS patients.
在本研究中，我们旨在展示阻塞性睡眠呼吸暂停综合征（OSAS）与颈动脉内膜中层厚度（IMT）之间的相关性，OSAS 已被证明具有独立的影响，而 Framingham 风险评分（FRS）则显示了整体心血管风险。
我们对 90 例连续就诊于我们睡眠诊所并接受多导睡眠图（PSG）检查的患者进行了研究，这些患者存在血管危险因素，但无临床动脉粥样硬化疾病。通过超声检查测量颈动脉 IMT，并使用 FRS 定义 10 年内冠心病（CHD）的风险。
与其他两组相比，重度 OSAS 组的 IMT 和 FRS 均显著增加。颈动脉 IMT 与呼吸暂停-低通气指数（AHI）、氧减指数（ODI）和血氧饱和度（SpO2）<90%的时间呈显著正相关，与睡眠时最低 SpO2 和平均 SpO2 呈显著负相关。在对照组和轻度 OSAS 组中，IMT 和 FRS 呈显著正相关（r：0.501，P：0.027；r：0.625，P<0.001），而在重度 OSAS 组中，IMT 和 FRS 之间未检测到显著相关性（r：0.321，P：0.06）。在回归分析中，AHI 和 ODI 被发现是颈动脉 IMT 的独立预测因子。ODI 被发现对动脉粥样硬化的进展有独立影响。
重度 OSAS 组颈动脉 IMT 的增加不能用经典的危险因素来解释。在这方面，FRS 可能不足以正确确定 OSAS 患者的心血管风险和疾病保护策略。
