糖尿病和心血管疾病与间歇性低氧血症的恶化有关。
Diabetes and cardiovascular diseases are associated with the worsening of intermittent hypoxaemia.
机构信息
Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
出版信息
J Sleep Res. 2022 Feb;31(1):e13441. doi: 10.1111/jsr.13441. Epub 2021 Aug 10.
Intermittent hypoxaemia is a risk factor for numerous diseases. However, the reverse pathway remains unclear. Therefore, we investigated whether pre-existing hypertension, diabetes or cardiovascular diseases are associated with the worsening of intermittent hypoxaemia. Among the included 2,535 Sleep Heart Health Study participants, hypertension (n = 1,164), diabetes (n = 170) and cardiovascular diseases (n = 265) were frequently present at baseline. All participants had undergone two polysomnographic recordings approximately 5.2 years apart. Covariate-adjusted linear regression analyses were utilized to investigate the difference in the severity of intermittent hypoxaemia at baseline between each comorbidity group and the group of participants free from all comorbidities (n = 1,264). Similarly, we investigated whether the pre-existing comorbidities are associated with the progression of intermittent hypoxaemia. Significantly higher oxygen desaturation index (β = 1.77 [95% confidence interval: 0.41-3.13], p = 0.011), desaturation severity (β = 0.07 [95% confidence interval: 0.00-0.14], p = 0.048) and desaturation duration (β = 1.50 [95% confidence interval: 0.31-2.69], p = 0.013) were observed in participants with pre-existing cardiovascular diseases at baseline. Furthermore, the increase in oxygen desaturation index (β = 3.59 [95% confidence interval: 1.78-5.39], p < 0.001), desaturation severity (β = 0.08 [95% confidence interval: 0.02-0.14], p = 0.015) and desaturation duration (β = 2.60 [95% confidence interval: 1.22-3.98], p < 0.001) during the follow-up were higher among participants with diabetes. Similarly, the increase in oxygen desaturation index (β = 2.73 [95% confidence interval: 1.15-4.32], p = 0.001) and desaturation duration (β = 1.85 [95% confidence interval: 0.62-3.08], p = 0.003) were higher among participants with cardiovascular diseases. These results suggest that patients with pre-existing diabetes or cardiovascular diseases are at increased risk for an expedited worsening of intermittent hypoxaemia. As intermittent hypoxaemia is an essential feature of sleep apnea, these patients could benefit from the screening and follow-up monitoring of sleep apnea.
间歇性低氧血症是许多疾病的危险因素。然而，其相反的影响途径尚不清楚。因此，我们研究了预先存在的高血压、糖尿病或心血管疾病是否与间歇性低氧血症的恶化有关。在纳入的 2535 名睡眠心脏健康研究参与者中，基线时高血压（n=1164）、糖尿病（n=170）和心血管疾病（n=265）较为常见。所有参与者均进行了两次大约相隔 5.2 年的多导睡眠图记录。采用协变量调整线性回归分析，研究每组合并症患者与无任何合并症的 1264 名参与者之间在基线时间歇性低氧血症严重程度的差异。同样，我们研究了预先存在的合并症是否与间歇性低氧血症的进展有关。基线时患有心血管疾病的参与者的氧减饱和指数（β=1.77[95%置信区间：0.41-3.13]，p=0.011）、减饱和严重程度（β=0.07[95%置信区间：0.00-0.14]，p=0.048）和减饱和持续时间（β=1.50[95%置信区间：0.31-2.69]，p=0.013）明显更高。此外，糖尿病患者的氧减饱和指数（β=3.59[95%置信区间：1.78-5.39]，p<0.001）、减饱和严重程度（β=0.08[95%置信区间：0.02-0.14]，p=0.015）和减饱和持续时间（β=2.60[95%置信区间：1.22-3.98]，p<0.001）在随访期间的增加幅度更高。同样，心血管疾病患者的氧减饱和指数（β=2.73[95%置信区间：1.15-4.32]，p=0.001）和减饱和持续时间（β=1.85[95%置信区间：0.62-3.08]，p=0.003）的增加幅度更高。这些结果表明，患有预先存在的糖尿病或心血管疾病的患者发生间歇性低氧血症恶化的风险增加。由于间歇性低氧血症是睡眠呼吸暂停的一个重要特征，这些患者可能受益于睡眠呼吸暂停的筛查和随访监测。
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