Koh Tae Kyung, Kang Eun-Ju, Bae Woo Yong, Kim Sung Wan, Kim Chul Hoon, Koo Soo Kweon, Kim Sang Jun, Kim Moon Sung, Lee Jae Hoon
Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Republic of Korea.
Department of Radiology, Dong-A University College of Medicine, Busan, Republic of Korea.
Auris Nasus Larynx. 2019 Aug;46(4):559-564. doi: 10.1016/j.anl.2018.11.015. Epub 2018 Dec 7.
To evaluate the relationship between obstructive sleep apnea (OSA) severity and carotid arterial calcification by quantitative analysis using airway computed tomography (CT).
This study included a total of 180 consecutive OSA patients aged 45-80years underwent polysomnography and airway CT between March 2014 and October 2016. The subjects were divided into three groups based on the results of the respiratory disturbance index (RDI): mild (RDI 5-14, n=29), moderate (RDI 15-29, n=50), and severe (RDI≥30, n=101). The extent of carotid arterial calcification on each airway CT scan was quantified according to the modified Agatston scoring method. Differences among the three groups in clinical characteristics including age, gender, body mass index (BMI), comorbid disease, blood pressure, total cholesterol, and carotid arterial calcification score (CarACS) were analyzed.
The severe OSA group showed significantly stronger predominance for male and smoker, higher prevalence of diabetes, and larger BMI than those of mild and moderate OSA groups. The mean CarACS was significantly different among the three groups (mild RDI: 4.3±13.4, moderate RDI: 7.4±28.8, severe RDI: 48.6±121.6, P=0.011). Univariate linear regression showed that RDI, age, hypertension, male sex and diabetes significantly influenced on the CarACS. In a multivariate linear regression model, the CarACS was related to age, male sex, and diabetes.
The patients with severe OSA showed larger CarACS and a higher prevalence of atherosclerotic risk factors. The CarACS was correlated with severity of OSA, which might be more dependent on the conventional risk factors of atherosclerosis.
通过气道计算机断层扫描（CT）定量分析评估阻塞性睡眠呼吸暂停（OSA）严重程度与颈动脉钙化之间的关系。
本研究纳入了2014年3月至2016年10月期间连续接受多导睡眠图和气道CT检查的180例年龄在45 - 80岁的OSA患者。根据呼吸紊乱指数（RDI）结果将受试者分为三组：轻度（RDI 5 - 14，n = 29）、中度（RDI 15 - 29，n = 50）和重度（RDI≥30，n = 101）。根据改良的阿加斯顿评分法对每次气道CT扫描上的颈动脉钙化程度进行量化。分析三组在年龄、性别、体重指数（BMI）、合并疾病、血压、总胆固醇和颈动脉钙化评分（CarACS）等临床特征方面的差异。
重度OSA组男性和吸烟者的优势明显更强，糖尿病患病率更高，BMI比轻度和中度OSA组更大。三组的平均CarACS有显著差异（轻度RDI：4.3±13.4，中度RDI：7.4±28.8，重度RDI：48.6±121.6，P = 0.011）。单变量线性回归显示RDI、年龄、高血压、男性性别和糖尿病对CarACS有显著影响。在多变量线性回归模型中，CarACS与年龄、男性性别和糖尿病有关。
重度OSA患者的CarACS更大，动脉粥样硬化危险因素的患病率更高。CarACS与OSA严重程度相关，这可能更多地依赖于动脉粥样硬化的传统危险因素。
