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阻塞性睡眠呼吸暂停低通气综合征合并冠心病与炎症因子、糖脂代谢、肥胖、胰岛素抵抗的关系研究。

Research on the Association Between Obstructive Sleep Apnea Hypopnea Syndrome Complicated With Coronary Heart Disease and Inflammatory Factors, Glycolipid Metabolism, Obesity, and Insulin Resistance.

机构信息

Department of Cardiology, Beijing Luhe Hospital, Capital of Medical University, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2022 Jul 1;13:854142. doi: 10.3389/fendo.2022.854142. eCollection 2022.

Abstract

The aim of this study is to explore the association between obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with coronary heart disease (CHD) and inflammatory factors, glycolipid metabolism, obesity, and insulin resistance. A total of 400 patients diagnosed with OSAHS who underwent polysomnography (PSG) monitoring in the Sleep Diagnosis and Treatment Center of Beijing Luhe Hospital from March 2015 to September 2018 were selected and divided into the OSAHS group ( = 200) and the OSAHS + CHD group ( = 200) according to disease condition. The questionnaire survey was conducted, the somatology indexes were measured, and the PSG, insulin, glycolipid metabolism parameters, and serum inflammatory factors were detected. Body weight, body mass index, waist circumference, and Epworth sleepiness scale (ESS) score were all significantly increased in the OSAHS + CHD group compared with those in the OSAHS group ( < 0.05). The microarousal index (MAI), apnea hypopnea index (AHI), cumulative percentage of time spent at oxygen saturation below 90% (CT90%), oxygen desaturation index (ODI), lowest oxygen saturation (LSaO), total apnea time (TAT), and mean oxygen saturation (MSaO) had statistically significant differences between the OSAHS + CHD group and the OSAHS group ( < 0.05). According to the Spearman correlation analysis of AHI, LSaO, MSaO, CT90%, ODI, and MAI with HOMA-IR in both groups, MAI, AHI, CT90%, and ODI were positively correlated with HOMA-IR ( > 0), while LSaO and MSaO were negatively correlated with HOMA-IR ( < 0). Compared with the OSAHS group, the OSAHS + CHD group had an obviously increased level of triglyceride (TG) ( < 0.05), and obviously increased levels of serum inflammatory factors C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interferon-γ (IFN-γ) ( < 0.05). The occurrence of OSAHS complicated with CHD is related to inflammatory factors, glycolipid metabolism, obesity rate, and HOMA-IR.

摘要

本研究旨在探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并冠心病(CHD)与炎症因子、糖脂代谢、肥胖和胰岛素抵抗的关系。选择 2015 年 3 月至 2018 年 9 月在北京潞河医院睡眠诊断治疗中心行多导睡眠图(PSG)监测诊断为 OSAHS 的 400 例患者,根据病情分为 OSAHS 组(n=200)和 OSAHS+CHD 组(n=200)。进行问卷调查,测量体脂指标,检测 PSG、胰岛素、糖脂代谢参数和血清炎症因子。与 OSAHS 组相比,OSAHS+CHD 组的体重、体质量指数、腰围和 Epworth 嗜睡量表(ESS)评分均显著升高(<0.05)。OSAHS+CHD 组的微觉醒指数(MAI)、呼吸暂停低通气指数(AHI)、血氧饱和度<90%累计时间百分比(CT90%)、氧减指数(ODI)、最低血氧饱和度(LSaO)、总呼吸暂停时间(TAT)和平均血氧饱和度(MSaO)均显著高于 OSAHS 组(<0.05)。对两组 AHI、LSaO、MSaO、CT90%、ODI 和 MAI 与 HOMA-IR 的 Spearman 相关分析显示,MAI、AHI、CT90%和 ODI 与 HOMA-IR 呈正相关(>0),而 LSaO 和 MSaO 与 HOMA-IR 呈负相关(<0)。与 OSAHS 组相比,OSAHS+CHD 组的甘油三酯(TG)水平明显升高(<0.05),血清炎症因子 C 反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和干扰素-γ(IFN-γ)水平明显升高(<0.05)。OSAHS 合并 CHD 的发生与炎症因子、糖脂代谢、肥胖率和 HOMA-IR 有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f345/9283718/304c0e7392aa/fendo-13-854142-g001.jpg

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