Karkinski Dimitar, Georgievski Oliver, Dzekova-Vidimliski Pavlina, Milenkovic Tatjana, Dokic Dejan
University Clinic of Pulmonology and Allergology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Clinical Biochemistry, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Open Access Maced J Med Sci. 2017 Mar 15;5(1):19-22. doi: 10.3889/oamjms.2017.011. Epub 2017 Jan 18.
There has been a great interest in the interaction between obstructive sleep apnea (OSA) and metabolic dysfunction, but there is no consistent data suggesting that OSA is a risk factor for dyslipidemia.
The aim of this cross-sectional study was to evaluate the prevalence of lipid abnormalities in patients suspected of OSA, referred to our sleep laboratory for polysomnography.
Two hundred patients referred to our hospital with suspected OSA, and all of them underwent for standard polysomnography. All patients with respiratory disturbance index (RDI) above 15 were diagnosed with OSA. In the morning after 12 hours fasting, the blood sample was collected from all patients. Blood levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL), were determined in all study patients. In the study, both OSA positive and OSA negative patients were divided according to the body mass index (BMI) in two groups. The first group with BMI ≤ 30 kg/m^2 and the second group with BMI > 30 kg/m^2.
OSA positive patients with BMI ≤ 30 kg/m^2 had statistically significant higher levels of triglycerides and total cholesterol, and statistically significant lower level of HDL compared to OSA negative patients with BMI ≤ 30. There were no statistically significant differences in age and LDL levels between these groups. OSA positive patients with BMI > 30 kg/m^2 had higher levels of triglycerides, total cholesterol and LDL and lower levels of HDL versus OSA negative patients with BMI > 30 kg/m^2, but without statistically significant differences.
OSA and obesity are potent risk factors for dyslipidemias. OSA could play a significant role in worsening of lipid metabolism in non-obese patients. But in obese patients, the extra weight makes the metabolic changes of lipid metabolism, and the role of OSA is not that very important like in non-obese patients.
阻塞性睡眠呼吸暂停（OSA）与代谢功能障碍之间的相互作用备受关注，但尚无一致数据表明OSA是血脂异常的危险因素。
本横断面研究的目的是评估因疑似OSA而转诊至我们睡眠实验室进行多导睡眠图检查的患者中血脂异常的患病率。
200例因疑似OSA转诊至我院的患者均接受了标准多导睡眠图检查。所有呼吸紊乱指数（RDI）高于15的患者被诊断为OSA。在禁食12小时后的早晨，采集所有患者的血样。测定所有研究患者的甘油三酯、总胆固醇、高密度脂蛋白胆固醇（HDL）和低密度脂蛋白胆固醇（LDL）的血液水平。在研究中，OSA阳性和OSA阴性患者均根据体重指数（BMI）分为两组。第一组BMI≤30kg/m²，第二组BMI>30kg/m²。
与BMI≤30的OSA阴性患者相比，BMI≤30kg/m²的OSA阳性患者甘油三酯和总胆固醇水平在统计学上显著更高，HDL水平在统计学上显著更低。这些组之间在年龄和LDL水平上无统计学显著差异。与BMI>30kg/m²的OSA阴性患者相比，BMI>30kg/m²的OSA阳性患者甘油三酯、总胆固醇和LDL水平更高，HDL水平更低，但无统计学显著差异。
OSA和肥胖是血脂异常的重要危险因素。OSA可能在非肥胖患者脂质代谢恶化中起重要作用。但在肥胖患者中，额外的体重导致脂质代谢的变化，OSA的作用不像在非肥胖患者中那么重要。
