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内脂素作为心房颤动患者阻塞性睡眠呼吸暂停的预测指标

Visfatin as a predictor of obstructive sleep apnea in atrial fibrillation patients.

作者信息

Szymanska Anna, Platek Anna E, Sierdzinski Janusz, Szymanski Filip M

机构信息

Department of Heart Diseases, Medial Centre of Postgraduate Education, Warsaw, Poland.

Department of General and Experimental Pathology, Centre for Preclinical Research and Technology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Sleep Breath. 2020 Sep;24(3):1215-1218. doi: 10.1007/s11325-020-02025-0. Epub 2020 Mar 13.

Abstract

BACKGROUND

Obstructive sleep apnea (OSA) often coexists with atrial fibrillation (AF) and makes the course of AF worse. The negative impact of OSA on AF may be due to atrial stretch, hypoxia, hypertension, obesity, fibrosis, and inflammation. Several mediators are thought to be responsible for this correlation, among them adipokines such as visfatin. This study aimed to assess the association between visfatin concentrations and OSA in patients with AF.

AIMS

This study aimed to assess the association between visfatin concentrations and OSA in AF patients.

METHODS

In a tertiary Cardiology Department, hospitalized patients previously diagnosed with AF were enrolled in the study. Diagnosis of OSA was made based on a respiratory polygraphy and patients had blood samples taken for assessment of plasma visfatin concentration.

RESULTS

A total of 266 patients with AF (65% men, age 57.6 ± 10.1) were enrolled, and 121 (45%) were diagnosed with OSA. Patients with OSA had higher visfatin concentrations than those without OSA (2.13 ± 0.17 vs. 1.70 ± 0.21 ng/mL; p = 0.04). Patients with mild OSA had visfatin levels equal to 1.77 ± 0.17 ng/mL, moderate OSA 2.38 ± 0.18 ng/mL, and severe OSA 3.55 ± 0.61 ng/mL (p for trend = 0.017). Multivariate regression analysis showed that increased visfatin concentrations were associated with the risk of OSA (odds ratio 1.92; 95% confidence interval 1.09-3.40).

CONCLUSIONS

Patients with AF who were diagnosed with OSA had significantly higher plasma visfatin levels which increased according to the severity of OSA. Furthermore, multivariate regression analysis identified visfatin concentration over 1.25 ng/mL, male sex, age over 59.1 years, and permanent AF as the factors showing independent correlation with OSA.

摘要

背景

阻塞性睡眠呼吸暂停(OSA)常与心房颤动(AF)并存,并使AF病情加重。OSA对AF的负面影响可能归因于心房牵张、缺氧、高血压、肥胖、纤维化和炎症。几种介质被认为与这种关联有关,其中包括内脂素等脂肪因子。本研究旨在评估AF患者内脂素浓度与OSA之间的关联。

目的

本研究旨在评估AF患者内脂素浓度与OSA之间的关联。

方法

在一家三级心脏病科,将先前诊断为AF的住院患者纳入研究。根据呼吸多导睡眠图诊断OSA,并采集患者血样以评估血浆内脂素浓度。

结果

共纳入266例AF患者(65%为男性,年龄57.6±10.1岁),其中121例(45%)被诊断为OSA。OSA患者的内脂素浓度高于无OSA患者(2.13±0.17 vs. 1.70±0.21 ng/mL;p = 0.04)。轻度OSA患者的内脂素水平为1.77±0.17 ng/mL,中度OSA患者为2.38±0.18 ng/mL,重度OSA患者为3.55±0.61 ng/mL(趋势p = 0.017)。多因素回归分析显示,内脂素浓度升高与OSA风险相关(比值比1.92;95%置信区间1.09 - 3.40)。

结论

诊断为OSA的AF患者血浆内脂素水平显著更高,且随OSA严重程度增加。此外,多因素回归分析确定内脂素浓度超过1.25 ng/mL、男性、年龄超过59.1岁和永久性AF为与OSA呈独立相关的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ffe/7426319/1a75a1331bd3/11325_2020_2025_Fig1_HTML.jpg

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