Yang Rui, Gao Chang, Yan Yizhi, Huang Yongwei, Wang Jianli, Zhang Chunmei, Ma Xiaowei, Li Nannan, Du Xiaoguo, Zhang Liqiang, Wang Ying, Li Rong, Qiao Jie
Reproductive Medical Center, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing, 100191, China.
Sleep Breath. 2022 Mar;26(1):497-503. doi: 10.1007/s11325-021-02376-2. Epub 2021 May 19.
To investigate the proportion and clinical characteristics of obstructive sleep apnea (OSA) in Chinese patients with polycystic ovarian syndrome (PCOS) through home sleep apnea test (HSAT) and to evaluate the reproductive endocrine and metabolic characteristics in these patients.
The study was a cross-sectional analysis of infertile PCOS patients who underwent sleep respiratory monitoring between January and December 2019 at Peking University Third Hospital Reproductive Medical Center and respiratory and critical care medicine department. The prevalence of OSA, body mass index (BMI), menstruation, reproductive endocrine, and metabolic characteristics were collected in patients with PCOS. Logistic regression was performed to identify significant relationships among these factors and OSA.
Amont 328 patients with PCOS, the prevalence of OSA was 40% (131/328), and six cases (5%) were severe. Univariate analysis showed that BMI and blood pressure were significantly higher in patients with OSA than in those without OSA (P < 0.05), whereas the anti-Mullerian hormone was lower than that in patients without OSA. In terms of glucose and lipid metabolism, the glycosylated hemoglobin (HbA1c), fasting plasma glucose, and fasting insulin levels were significantly higher in patients with PCOS and comorbid OSA than in those without OSA (all P < 0.05). Patients with OSA also had higher triglyceride, low-density lipoprotein cholesterol, and high-sensitivity C-reactive protein levels and lower high-density lipoprotein cholesterol levels (P < 0.05). Logistic regression analysis revealed that higher BMI, elevated serum testosterone, and decreased high-density lipoprotein cholesterol (HDL-C) are correlated with occurrence of OSA (P < 0.05).
OSA in patients with PCOS was associated with multiple alterations in indexes of reproductive endocrine and metabolic disorders.
通过家庭睡眠呼吸暂停测试(HSAT)调查中国多囊卵巢综合征(PCOS)患者中阻塞性睡眠呼吸暂停(OSA)的比例和临床特征,并评估这些患者的生殖内分泌和代谢特征。
本研究是对2019年1月至12月在北京大学第三医院生殖医学中心及呼吸与危重症医学科接受睡眠呼吸监测的不孕PCOS患者进行的横断面分析。收集PCOS患者的OSA患病率、体重指数(BMI)、月经情况、生殖内分泌和代谢特征。进行逻辑回归分析以确定这些因素与OSA之间的显著关系。
在328例PCOS患者中,OSA患病率为40%(131/328),其中重度患者6例(5%)。单因素分析显示,OSA患者的BMI和血压显著高于无OSA患者(P<0.05),而抗苗勒管激素低于无OSA患者。在糖脂代谢方面,合并OSA的PCOS患者的糖化血红蛋白(HbA1c)、空腹血糖和空腹胰岛素水平显著高于无OSA患者(均P<0.05)。OSA患者的甘油三酯、低密度脂蛋白胆固醇和高敏C反应蛋白水平也较高,高密度脂蛋白胆固醇水平较低(P<0.05)。逻辑回归分析显示,较高的BMI、血清睾酮升高和高密度脂蛋白胆固醇(HDL-C)降低与OSA的发生相关(P<0.05)。
PCOS患者的OSA与生殖内分泌和代谢紊乱指标的多种改变有关。