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自述打鼾与动脉僵硬度的关联:来自 Brisighella 心脏研究的数据。

Association between self-reported snoring and arterial stiffness: data from the Brisighella Heart Study.

机构信息

Medical and Surgical Sciences Department, U.O. Medicina Interna Borghi, Sant'Orsola-Malpighi University Hospital, University of Bologna, Via Albertoni, 15, 40138, Bologna, Italy.

出版信息

Intern Emerg Med. 2016 Feb;11(1):77-83. doi: 10.1007/s11739-015-1310-9. Epub 2015 Sep 28.

DOI:10.1007/s11739-015-1310-9
PMID:26415727
Abstract

The correlation of both obstructive sleep apnoea syndrome (OSAS) and snoring with cardiovascular risk is well known, but its investigation is complex and not suitable for studying large cohorts of subjects. Thus, we prospectively evaluated 1476 non-pharmacologically treated subjects selected from the last survey of the Brisighella Heart Study. Snoring and sleep apnoea were investigated asking the subjects if they were aware of snoring during the night, and if this was associated with episodes of apnoea. A full set of clinical and laboratory parameters were evaluated, while augmentation index (AIx), and pulse wave velocity (PWV) were recorded with the Vicorder(®) apparatus. A logistic regression analysis identifies as main independent predictors of AIx age (OR 1.058, 95% CI 1.043-1.065, p < 0.001), Body Mass Index (OR 1.046, 95% CI 1.014-1.079, p = 0.005), and apolipoprotein B (OR 1.014, 95% CI 1.004-1.023, p = 0.001). The main independent predictors of PWV are snoring (OR 1.215, 95% CI 1.083-1.390, p < 0.001), and snoring with apnoea (OR 1.351, 95% CI 1.135-1.598, p = 0.014), age (OR 1.078, 95% CI 1.052-1.089, p < 0.001), serum uric acid [SUA] (OR 1.093, 95% CI 1.026-1.151, p < 0.001) and mean arterial pressure (OR 1.042, 95% CI 1.024-1.056, p < 0.001). In conclusion, in our cohort of overall healthy subjects, self-reported snoring and sleep apnoea are independently associated with a higher PVW, and AIx is statistically significantly higher in snorers with or without sleep apnoea than in non-snorers. Body Mass Index and apolipoprotein B are associated with AIx, while SUA and mean arterial pressure are related to PWV.

摘要

众所周知,阻塞性睡眠呼吸暂停综合征(OSAS)和打鼾与心血管风险密切相关,但对其进行调查较为复杂,不适合对大量受试者进行研究。因此,我们前瞻性地评估了 1476 名非药物治疗的受试者,这些受试者是从 Brisighella 心脏研究的最后一次调查中选择的。通过询问受试者是否在夜间意识到打鼾以及是否与呼吸暂停发作有关,来调查打鼾和睡眠呼吸暂停情况。评估了一整套临床和实验室参数,同时使用 Vicorder(®)设备记录了增强指数(AIx)和脉搏波速度(PWV)。逻辑回归分析确定年龄(OR 1.058,95%CI 1.043-1.065,p < 0.001)、体重指数(OR 1.046,95%CI 1.014-1.079,p = 0.005)和载脂蛋白 B(OR 1.014,95%CI 1.004-1.023,p = 0.001)是 AIx 的主要独立预测因子。PWV 的主要独立预测因子是打鼾(OR 1.215,95%CI 1.083-1.390,p < 0.001)和打鼾伴呼吸暂停(OR 1.351,95%CI 1.135-1.598,p = 0.014)、年龄(OR 1.078,95%CI 1.052-1.089,p < 0.001)、血尿酸(SUA)(OR 1.093,95%CI 1.026-1.151,p < 0.001)和平均动脉压(OR 1.042,95%CI 1.024-1.056,p < 0.001)。总之,在我们的整体健康受试者队列中,自我报告的打鼾和睡眠呼吸暂停与更高的 PVW 独立相关,与非打鼾者相比,有或无睡眠呼吸暂停的打鼾者的 AIx 显著更高。体重指数和载脂蛋白 B 与 AIx 相关,而血尿酸和平均动脉压与 PWV 相关。

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