Mei M, Feng Z P, Song Y, He W W, Cheng Q F, Yang S M, Hu J B, Wang K R, Xu Z X, Du Z P, Li Q F
Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Zhonghua Nei Ke Za Zhi. 2020 Nov 1;59(11):866-871. doi: 10.3760/cma.j.cn112138-20191212-00813.
To explore the proportion of obstructive sleep apnea (OSA) in primary aldosteronism (PA) in Chinese population and compare the clinical characteristics between PA patients with OSA and those without. A total of 96 patients diagnosed with PA from September 2015 to November 2018 were recruited in this study. OSA was screened by cardio-respiratory polygraphy. According to the apnea hypopnea index (AHI), the patients were divided into PA with OSA group (AHI ≥5 times) and PA without OSA group (AHI<5 times). Among all patients (96), 69 (71.9%) were with OSA, among them 22 patients (22.9%) were with mild OSA, 17 patients (17.7%) were with moderate OSA and 30 patients (31.3%) were with severe OSA. Compared with the patients without OSA, the patients with OSA were elder, and had higher levels of body mass index (BMI), waist circumference (WC), hip circumference (HC), creatinine (CR) and glycosylated haemoglobin (HbA1c) (<0.05), but lower concentrations of plasma aldosterone (PAC), supine aldosterone renin concentration ratio(ARR) and the PAC after the diagnosis test (<0.05). Spearman correlation analyses showed that BMI, WC, HC, CR and HbA1c were positively correlated with AHI (<0.05), while high-density lipoproteincholesterol (HDL-C), supine-PAC and saline infusion test(SIT)-post PAC were negatively correlated with AHI (<0.05). The proportion of OSA in PA patients is relatively high (71.9%). Metabolic abnormalities are more common in PA patients with OSA, indicating that screening for OSA should be carried out routinely in PA patients.
探讨中国人群原发性醛固酮增多症（PA）中阻塞性睡眠呼吸暂停（OSA）的比例，并比较伴有OSA和不伴有OSA的PA患者的临床特征。本研究纳入了2015年9月至2018年11月期间诊断为PA的96例患者。通过心肺多导睡眠图筛查OSA。根据呼吸暂停低通气指数（AHI），将患者分为伴OSA的PA组（AHI≥5次）和不伴OSA的PA组（AHI<5次）。在所有96例患者中，69例（71.9%）伴有OSA，其中22例（22.9%）为轻度OSA，17例（17.7%）为中度OSA，30例（31.3%）为重度OSA。与不伴有OSA的患者相比，伴有OSA的患者年龄更大，体重指数（BMI）、腰围（WC）、臀围（HC）、肌酐（CR）和糖化血红蛋白（HbA1c）水平更高（<0.05），但血浆醛固酮（PAC）、卧位醛固酮肾素浓度比值（ARR）及诊断试验后的PAC浓度更低（<0.05）。Spearman相关性分析显示，BMI、WC、HC、CR和HbA1c与AHI呈正相关（<0.05），而高密度脂蛋白胆固醇（HDL-C）、卧位PAC和生理盐水输注试验（SIT）后PAC与AHI呈负相关（<0.05）。PA患者中OSA的比例相对较高（71.9%）。代谢异常在伴有OSA的PA患者中更为常见，提示应在PA患者中常规筛查OSA。
