阻塞性睡眠呼吸暂停的严重程度增加动脉硬化的风险。

The Severity of Obstructive Sleep Apnea Increases the Risk of Arteriosclerosis.

机构信息

Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025 Shanghai, China.

Daning Community Health Service Center, 031499 Shanghai, China.

出版信息

Rev Cardiovasc Med. 2022 Mar 9;23(3):94. doi: 10.31083/j.rcm2303094.

DOI:10.31083/j.rcm2303094

PMID:35345261

Abstract

BACKGROUND

Obstructive sleep apnea (OSA) is a common disorder worldwide. It is associated with myocardial remodeling and arteriosclerosis in patients with hypertension. Our study investigated the relationship between OSA severity and arteriosclerosis and blood pressure in an Asian population.

METHODS

We enrolled 365 subjects from July 2018 to December 2020 at Ruijin Hospital. We recorded data from the medical history and collected blood samples from all participants. We performed 24-hour ambulatory Blood Pressure (BP) monitoring and Carotid-femoral pulse wave velocity (cf-PWV) measurements. Overnight polysomnography (PSG) was performed using Respironics Alice PDxSleepware.

RESULTS

PSG was performed in a total of 365 subjects; mean age of 49.1 ± 12.8 years and Body Mass Index (BMI) 28.1 ± 3.8 kg/m2. The majority (89.3%) were male. The office systolic BP was significantly higher in the moderate to severe group than mild OSA group (148 ± 21 mmHg vs 139 ± 19 mmHg, < 0.01). The subjects with moderate to severe OSA presented higher cf-PWV values than those in the mild group (10.03 ± 3.67 m/s vs 7.62 ± 1.48 m/s, < 0.01). BMI was significantly higher in the moderate to severe than the mild OSA groups (28.3 ± 4.0 kg/m2 vs 27.5 ± 3.2 kg/m2, < 0.05). The Pearson correlation showed that the apnea-hypopnea index (AHI) was significantly and positively correlated with cf-PWV ( = 0.217, < 0.01), Age ( = 0.148, 0.01), BMI ( = 0.228, < 0.01) and HbA1c ( = 0.172, < 0.01). After adjusting for age, BMI, low density lipoprotein cholesterin (LDL-c), FGB, AHI, estimated Glomerular Filtration Rate (eGFR), Night BP, office diastolic BP and Day BP in Logistic regression model, AHI (OR = 1.03, 95% CI: 1.01-1.05) and office diastolic pressure (OR = 1.04, 95% CI: 1.00-1.08) and age (OR = 1.12, 95% CI: 1.06-1.19) were independent risk factors for arteriosclerosis.

CONCLUSIONS

The severity of OSA was positively correlated with pulse wave velocity. AHI, office BP and age were independent risk factors for arteriosclerosis.

摘要

背景

阻塞性睡眠呼吸暂停（OSA）是一种全球常见的疾病。它与高血压患者的心肌重构和动脉硬化有关。我们的研究调查了亚洲人群中 OSA 严重程度与动脉硬化和血压之间的关系。

方法

我们于 2018 年 7 月至 2020 年 12 月在瑞金医院招募了 365 名受试者。我们记录了病史数据，并从所有参与者中采集了血液样本。我们进行了 24 小时动态血压（BP）监测和颈股脉搏波速度（cf-PWV）测量。整夜多导睡眠图（PSG）使用 Respironics Alice PDxSleepware 进行。

结果

总共对 365 名受试者进行了 PSG 检查；平均年龄为 49.1±12.8 岁，体重指数（BMI）为 28.1±3.8kg/m2。大多数（89.3%）为男性。与轻度 OSA 组相比，中重度 OSA 组的诊室收缩压明显更高（148±21mmHg 比 139±19mmHg，<0.01）。中重度 OSA 患者的 cf-PWV 值高于轻度 OSA 组（10.03±3.67m/s 比 7.62±1.48m/s，<0.01）。中重度 OSA 组的 BMI 明显高于轻度 OSA 组（28.3±4.0kg/m2 比 27.5±3.2kg/m2，<0.05）。Pearson 相关分析显示，呼吸暂停低通气指数（AHI）与 cf-PWV 呈显著正相关（=0.217，<0.01），与年龄（=0.148，0.01）、BMI（=0.228，<0.01）和糖化血红蛋白（HbA1c）（=0.172，<0.01）。在调整年龄、BMI、低密度脂蛋白胆固醇（LDL-c）、纤维蛋白原（FGB）、AHI、估算肾小球滤过率（eGFR）、夜间 BP、诊室舒张压和日间 BP 后，在 logistic 回归模型中，AHI（OR=1.03，95%CI：1.01-1.05）和诊室舒张压（OR=1.04，95%CI：1.00-1.08）和年龄（OR=1.12，95%CI：1.06-1.19）是动脉硬化的独立危险因素。