Song Tae-Jin, Park Jung-Hyun, Choi Kang Hyun, Kim Ju-Hee, Choi Yunseo, Chang Yoonkyung, Kim Hyeon Jin, Moon Jangsup, Kim Yong-Jae, Lee Hyang Woon
Department of Neurology, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, South Korea.
Department of Medical Science, Ewha Womans University School of Medicine, Seoul, South Korea.
Sleep Breath. 2017 Sep;21(3):639-646. doi: 10.1007/s11325-016-1450-9. Epub 2017 Feb 7.
Intracranial cerebral atherosclerosis (ICAS) is one of critical atherosclerosis which closely related with stroke. Obstructive sleep apnea (OSA) is associated with systemic atherosclerosis, but it is unclear whether OSA is related with the presence of ICAS. We aimed to investigate the association between the presence of ICAS and severity of OSA in patients with suspected OSA.
This retrospective, cross-sectional study included 283 patients who suspected OSA (presence of one or more OSA-related symptom and high-risk category in Berlin questionnaire) and underwent polysomnography and brain magnetic resonance angiography (MRA). The ICAS was defined as ≥50% decrease of luminal diameter in MRA. The severity of OSA was defined by apnea-hypopnea index (AHI).
The mean age was 60.7 ± 13.5 years, and 55.8% (158/283) were male in all included patients. The 53 (18.7%) patients had ICAS and 117 (41.3%) patients had moderate to severe OSA (AHI ≥ 15). Higher AHI was noted in patients with ICAS compared to those without ICAS (31.7 ± 25.8 versus 15.2 ± 17.4, p = 0.001). In multivariable logistic analyses, after adjusting for age, sex, and variables with p < 0.1 in univariable analyses (hypertension, diabetes mellitus, atrial fibrillation, previous stroke history, body mass index, lipid-lowing agents, arousal index, and minimum oxygen saturation), moderate to severe OSA were independently related with the presence of ICAS (odds ratio 4.17, 95% confidence interval 1.40-12.40, p = 0.010).
Our findings suggest that moderate to severe OSA is associated with the presence of ICAS in patients with suspected OSA.
颅内脑动脉粥样硬化（ICAS）是与中风密切相关的关键动脉粥样硬化之一。阻塞性睡眠呼吸暂停（OSA）与全身动脉粥样硬化有关，但尚不清楚OSA是否与ICAS的存在有关。我们旨在研究疑似OSA患者中ICAS的存在与OSA严重程度之间的关联。
这项回顾性横断面研究纳入了283例疑似OSA的患者（在柏林问卷中存在一种或多种与OSA相关的症状且属于高危类别），并接受了多导睡眠图和脑磁共振血管造影（MRA）检查。ICAS定义为MRA中管腔直径减少≥50%。OSA的严重程度由呼吸暂停低通气指数（AHI）定义。
所有纳入患者的平均年龄为60.7±13.5岁，男性占55.8%（158/283）。53例（18.7%）患者有ICAS，117例（41.3%）患者有中度至重度OSA（AHI≥15）。与无ICAS的患者相比，有ICAS的患者AHI更高（31.7±25.8对15.2±17.4，p=0.001）。在多变量逻辑分析中，在调整年龄、性别以及单变量分析中p<0.1的变量（高血压、糖尿病、心房颤动、既往中风史、体重指数、降脂药物、觉醒指数和最低血氧饱和度）后，中度至重度OSA与ICAS的存在独立相关（比值比4.17，95%置信区间1.40-12.40，p=0.010）。
我们的研究结果表明，中度至重度OSA与疑似OSA患者中ICAS的存在有关。
