Nadeem Rashid, Singh Mukesh, Nida Mahwish, Waheed Irfan, Khan Adnan, Ahmed Saeed, Naseem Jawed, Champeau Daniel
Rosalind Franklin University of Medicine and Science,Chicago Medical School, North Chicago,IL.
Department of Cardiology, James A Lovell Federal Health Care Center, North Chicago, IL.
J Clin Sleep Med. 2014 May 15;10(5):475-89. doi: 10.5664/jcsm.3690.
Obstructive sleep apnea (OSA) is associated with obesity, metabolic syndrome, and dyslipidemia, which may be related to decrease androgen levels found in OSA patients. Dyslipidemia may contribute to atherosclerosis leading to increasing risk of heart disease.
Systematic review was conducted using PubMed and Cochrane library by utilizing different combinations of key words; sleep apnea, obstructive sleep apnea, serum lipids, dyslipidemia, cholesterol, total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), and triglyceride (TG). Inclusion criteria were: English articles, and studies with adult population in 2 groups of patients (patients with OSA and without OSA). A total 96 studies were reviewed for inclusion, with 25 studies pooled for analysis.
Sixty-four studies were pooled for analysis; since some studies have more than one dataset, there were 107 datasets with 18,116 patients pooled for meta-analysis. All studies measured serum lipids. Total cholesterol pooled standardized difference in means was 0.267 (p = 0.001). LDL cholesterol pooled standardized difference in means was 0.296 (p = 0.001). HDL cholesterol pooled standardized difference in means was -0.433 (p = 0.001). Triglyceride pooled standardized difference in means was 0.603 (p = 0.001). Meta-regression for age, BMI, and AHI showed that age has significant effect for TC, LDL, and HDL. BMI had significant effect for LDL and HDL, while AHI had significant effect for LDL and TG.
Patients with OSA appear to have increased dyslipidemia (high total cholesterol, LDL, TG, and low HDL).
阻塞性睡眠呼吸暂停(OSA)与肥胖、代谢综合征和血脂异常有关,这可能与OSA患者雄激素水平降低有关。血脂异常可能导致动脉粥样硬化,增加心脏病风险。
通过使用关键词“睡眠呼吸暂停”“阻塞性睡眠呼吸暂停”“血脂”“血脂异常”“胆固醇”“总胆固醇”“低密度脂蛋白(LDL)”“高密度脂蛋白(HDL)”和“甘油三酯(TG)”的不同组合,在PubMed和Cochrane图书馆进行系统综述。纳入标准为:英文文章,以及针对两组成年患者(OSA患者和非OSA患者)的研究。共审查了96项研究以纳入分析,其中25项研究进行汇总分析。
64项研究进行汇总分析;由于一些研究有多个数据集,因此共有107个数据集,18116名患者纳入荟萃分析。所有研究均测量了血脂。总胆固醇汇总的标准化均值差异为0.267(p = 0.001)。LDL胆固醇汇总的标准化均值差异为0.296(p = 0.001)。HDL胆固醇汇总的标准化均值差异为-0.433(p = 0.001)。甘油三酯汇总的标准化均值差异为0.603(p = 0.001)。年龄、BMI和AHI的荟萃回归显示,年龄对总胆固醇、LDL和HDL有显著影响。BMI对LDL和HDL有显著影响,而AHI对LDL和TG有显著影响。
OSA患者似乎血脂异常增加(总胆固醇、LDL、TG升高,HDL降低)。