Duman Hakan, Özyurt Songül
Faculty of Medicine, Department of Cardiology, Recep Tayyip Erdoğan University, Rize, Turkey.
Faculty of Medicine, Department of Chest Diseases, Recep Tayyip Erdoğan University, Rize, Turkey.
Interv Med Appl Sci. 2018 Dec;10(4):179-185. doi: 10.1556/1646.10.2018.39.
Obstructive sleep apnea (OSA) is a chronic, progressive disease that can cause cardiovascular complications and atherosclerosis. We evaluated the relationship between serum bilirubin levels and carotid intima-media thickness (cIMT), as a surrogate marker of subclinical atherosclerosis, in patients with OSA.
We enrolled 84 consecutive patients with OSA. The patients underwent ultrasonography, polysomnography, and echocardiography. Blood samples were obtained from all of the subjects, which were used for biochemical comparisons. The patients were divided into groups according to cIMT values (<0.9 vs. >0.9 mm).
The patient population consisted of 84 OSA patients (mean age: 54.2 + 8.0 years, 62.9% male). The OSA patients with cIMT ≥0.9 had significantly elevated high-sensitive C-reactive protein (hsCRP), Oxygen desaturation index, apnea-hypopnea index (AHI), and significantly lower total and indirect bilirubin levels. Multivariate regression analyses revealed that total bilirubin, hsCRP, and AHI were the independent predictors of subclinical atherosclerosis. There was a negative correlation between total bilirubin and cIMT.
This study showed that high hsCRP and low serum total bilirubin levels could be paving the way for the development of subclinical atherosclerosis. Simple measures such as total bilirubin may provide predictive information regarding the risk of cardiovascular disease in patients with OSA.
阻塞性睡眠呼吸暂停（OSA）是一种慢性进行性疾病，可导致心血管并发症和动脉粥样硬化。我们评估了OSA患者血清胆红素水平与作为亚临床动脉粥样硬化替代标志物的颈动脉内膜中层厚度（cIMT）之间的关系。
我们连续纳入了84例OSA患者。患者接受了超声检查、多导睡眠图检查和超声心动图检查。从所有受试者采集血样用于生化比较。根据cIMT值（<0.9 vs.>0.9 mm）将患者分组。
患者群体包括84例OSA患者（平均年龄：54.2±8.0岁，62.9%为男性）。cIMT≥0.9的OSA患者高敏C反应蛋白（hsCRP）、氧饱和度下降指数、呼吸暂停低通气指数（AHI）显著升高，总胆红素和间接胆红素水平显著降低。多变量回归分析显示，总胆红素、hsCRP和AHI是亚临床动脉粥样硬化的独立预测因素。总胆红素与cIMT之间存在负相关。
本研究表明，高hsCRP和低血清总胆红素水平可能为亚临床动脉粥样硬化的发展铺平道路。诸如总胆红素等简单指标可能为OSA患者心血管疾病风险提供预测信息。
