Silva Luciana Oliveira E, Guimarães Thais M, Luz Gabriela P, Coelho Glaury, Badke Luciana, Almeida Ildonete R, Millani-Carneiro Aline, Tufik Sergio, Bittencourt Lia, Togeiro Sonia M
1 Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo , São Paulo, Brazil .
2 Departamento de Pneumologia, Universidade Federal de São Paulo , São Paulo, Brazil .
Metab Syndr Relat Disord. 2018 Feb;16(1):6-12. doi: 10.1089/met.2017.0075. Epub 2017 Nov 17.
Mild obstructive sleep apnea (OSA) is a highly prevalent disorder in adults. However, it is not clear whether mild OSA has significant metabolic complications. This study examined the prevalence of metabolic syndrome (MS) in patients with mild OSA compared to control group.
Adults (18-65 years of age) of both genders with a body mass index (BMI) ≤35 kg/m were included. The mild OSA group comprised of patients with an apnea-hypopnea index (AHI) score of ≥5 but ≤15 events/hr of sleep, independent of other symptoms. The control group (CG) comprised individuals with an AHI of <5 events/hr of sleep and an Epworth Sleepiness Scale score of <10. The following were used for both groups: two questionnaires on sleepiness, the maintenance of wakefulness test, and full-night polysomnography. Anthropometric measurements and fasting blood samples were obtained, including fasting glucose and insulin, total cholesterol and its subfractions [low-density lipoprotein, very low-density lipoprotein, and low-density lipoprotein cholesterol (HDL-c)], triglycerides (TG), and the TG/HDL-c ratio. In addition, the quantitative insulin sensitivity check index and homeostasis model assessment indices were calculated.
Thirty-two percent of mild OSA patients had MS, 43.5% of mild OSA patients had hypertension, 14% showed dyslipidemia, and 56% had prediabetes. The OSA group showed increased TG (CG: 90.0 ± 51.9 vs. OSA: 140.3 ± 78.2 mg/dL, P = 0.004), and TG/HDL-c (CG: 1.9 ± 1.4 vs. OSA: 3.1 ± 2.0, P = 0.05), independent of adjustments. Independent of obesity (BMI <30 kg/m), there was a negative correlation between total cholesterol and TG with mean oxygen saturation, independent of obesity (BMI <30 kg/m).
Our findings showed dysregulation in lipid profiles after adjustments for confounders in the mild OSA group, and there was a correlation between these parameters and sleep hypoxemia. The TG/HDL-c ratio in particular was high, suggesting that it might be investigated as a marker of a detrimental metabolic profile in these patients.
轻度阻塞性睡眠呼吸暂停(OSA)在成年人中是一种高度流行的疾病。然而,尚不清楚轻度OSA是否具有显著的代谢并发症。本研究比较了轻度OSA患者与对照组中代谢综合征(MS)的患病率。
纳入年龄在18 - 65岁、体重指数(BMI)≤35kg/m²的成年男女。轻度OSA组由呼吸暂停低通气指数(AHI)评分≥5但≤15次/小时睡眠事件的患者组成,不考虑其他症状。对照组(CG)由睡眠时AHI < 5次/小时且爱泼华嗜睡量表评分< 10的个体组成。两组均采用以下方法:两份关于嗜睡的问卷、清醒维持测试和全夜多导睡眠图。进行人体测量并采集空腹血样,包括空腹血糖和胰岛素、总胆固醇及其亚组分[低密度脂蛋白、极低密度脂蛋白和高密度脂蛋白胆固醇(HDL - c)]、甘油三酯(TG)以及TG/HDL - c比值。此外,计算定量胰岛素敏感性检查指数和稳态模型评估指数。
32%的轻度OSA患者患有MS,43.5%的轻度OSA患者患有高血压,14%表现为血脂异常,56%患有糖尿病前期。OSA组的TG(CG:90.0±51.9 vs. OSA:140.3±78.2mg/dL,P = 0.004)和TG/HDL - c(CG:1.9±1.4 vs. OSA:3.1±2.0,P = 0.05)升高,不受调整因素影响。在不考虑肥胖(BMI < 30kg/m²)的情况下,总胆固醇和TG与平均血氧饱和度之间存在负相关。
我们的研究结果表明,在对轻度OSA组的混杂因素进行调整后,脂质谱存在失调,并且这些参数与睡眠低氧血症之间存在相关性。特别是TG/HDL - c比值较高,表明它可能作为这些患者有害代谢谱的一个标志物进行研究。