Korcarz Claudia E, Stein James H, Peppard Paul E, Young Terry B, Barnet Jodi H, Nieto F Javier
University of Wisconsin School of Medicine and Public Health, Madison, WI.
Sleep. 2014 Oct 1;37(10):1707-13. doi: 10.5665/sleep.4086.
To examine the combined impact of sleep disordered breathing (SDB) and metabolic syndrome (MetS) in endothelial dysfunction.
Cross-sectional assessment of endothelial function, MetS and SDB status in a population-based sample.
Community-based cohort.
Participants (n = 431) from the Wisconsin Sleep Cohort were studied between 2004 and 2007. MetS was defined following the National Cholesterol Education Program criteria. SDB severity was defined by the apnea-hypopnea index ([AHI] events/h of sleep) during overnight polysomnography. Fasting lipids, glucose, and insulin were measured and homeostasis model assessment was calculated to quantify insulin resistance (HOMA-IR). Multivariable linear regression was used to assess associations of brachial artery flow-mediated dilation (FMD) with SDB, MetS, and their interaction.
None.
Participants averaged 60.2 years of age (SD 7.8 years), 44% were female, and 97% Caucasian. MetS was present in 35%; 22% had AHI ≥ 15 events/hour. Of the no-MetS group, 7% had AHI ≥ 15 events/hour. FMD (mean 5.5%; SD 3.5%) was inversely associated with age (r = -0.16, P = 0.001) and mean brachial artery diameter (r = -0.29, P < 0.001). Multivariate linear models adjusted for CVD risk factors showed that the negative association between SDB and FMD was present among subjects with MetS (β FMD(per unit log2(AHI+1)) = -0.55%, P = 0.014), but not among subjects with normal metabolic function (β = 0.13, not significant), P for interaction = 0.011.
Sleep disordered breathing and concurrent metabolic syndrome are synergistically associated with worse endothelial function. Individuals with both of these conditions appear to be at a significantly higher risk for cardiovascular disease complications.
探讨睡眠呼吸障碍（SDB）和代谢综合征（MetS）对内皮功能障碍的综合影响。
对基于人群样本的内皮功能、MetS和SDB状态进行横断面评估。
基于社区的队列研究。
2004年至2007年期间对来自威斯康星睡眠队列的参与者（n = 431）进行了研究。MetS根据国家胆固醇教育计划标准定义。SDB严重程度通过夜间多导睡眠图期间的呼吸暂停低通气指数（[AHI]事件/小时睡眠）定义。测量空腹血脂、血糖和胰岛素，并计算稳态模型评估以量化胰岛素抵抗（HOMA-IR）。使用多变量线性回归评估肱动脉血流介导的扩张（FMD）与SDB、MetS及其相互作用之间的关联。
无。
参与者平均年龄为60.2岁（标准差7.8岁），44%为女性，97%为白种人。35%的人患有MetS；22%的人AHI≥15次事件/小时。在无MetS组中，7%的人AHI≥15次事件/小时。FMD（平均5.5%；标准差3.5%）与年龄呈负相关（r = -0.16，P = 0.001）和肱动脉平均直径呈负相关（r = -0.29，P < 0.001）。针对心血管疾病危险因素进行调整的多变量线性模型显示，SDB与FMD之间的负相关在患有MetS的受试者中存在（βFMD（每单位log2（AHI + 1））= -0.55%，P = 0.014），但在代谢功能正常的受试者中不存在（β = 0.13，无显著性），交互作用的P值 = 0.011。
睡眠呼吸障碍和并发代谢综合征与内皮功能恶化协同相关。同时患有这两种疾病的个体似乎患心血管疾病并发症的风险显著更高。
