Department of Internal Medicine, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
Department of ORL-HNS, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
Saudi J Gastroenterol. 2022 Sep-Oct;28(5):355-361. doi: 10.4103/sjg.sjg_134_22.
Patients with sleep disturbances have gastrointestinal symptoms. Breath hydrogen (H) and methane (CH) indicating small intestinal bacterial overgrowth (SIBO) might be related with these symptoms. The study was conducted to assess the link between breath profiles and untreated obstructive sleep apnea (OSA).
: This prospective study enrolled consecutive patients with OSA using polysomnography. Heart rate variability (HRV) was used as a measurement for the balance of autonomic nervous system during polysomnography. Glucose breath test (GBT) to evaluate breath H and CH and bowel symptom questionnaire to investigate associated intestinal symptoms were performed.
Among 52 patients with OSA, 16 (30.8%) showed positivity to GBT. Although no significant difference was shown in GBT positivity between patients with healthy controls and patients with OSA (13.3% vs 30.8%, P = 0.109), breath H and CH levels in the OSA group were significantly higher than those in controls (P < 0.05). Flatulence was significantly common in OSA groups with GBT positivity than those without GBT positivity. Multivariate analysis demonstrated that waist-to-hip ratio (odds ratio = 12.889; 95% confidence interval (CI): 1.257-132.200; P = 0.031) and low-to-high-frequency ratio of HRV (odds ratio = 1.476; 95% CI: 1.013-2.151, P = 0.042) are independently related to GBT positivity in patients with OSA.
: Elevated breath H or CH after glucose load might not be an uncommon finding in patients with untreated OSA. Abdominal obesity and autonomic imbalance dysfunction are significantly associated with GBT positivity in OSA patients. SIBO could be considered as target for therapeutic management in OSA patients.
睡眠障碍患者存在胃肠道症状。呼气氢（H）和甲烷（CH）表明小肠细菌过度生长（SIBO）可能与这些症状有关。本研究旨在评估呼吸特征与未经治疗的阻塞性睡眠呼吸暂停（OSA）之间的关系。
这项前瞻性研究纳入了使用多导睡眠图进行 OSA 检测的连续患者。心率变异性（HRV）被用作多导睡眠图期间自主神经系统平衡的测量指标。进行葡萄糖呼气测试（GBT）以评估呼气 H 和 CH，以及肠道症状问卷以调查相关的肠道症状。
在 52 例 OSA 患者中，16 例（30.8%）GBT 检测呈阳性。尽管在健康对照组和 OSA 患者之间，GBT 阳性率无显著差异（13.3%比 30.8%，P=0.109），但 OSA 组的呼气 H 和 CH 水平明显高于对照组（P<0.05）。在 GBT 阳性的 OSA 组中，比 GBT 阴性的 OSA 组中，更常见的是气胀。多变量分析表明，腰围与臀围比（比值比=12.889；95%置信区间（CI）：1.257-132.200；P=0.031）和 HRV 的低至高频率比（比值比=1.476；95%CI：1.013-2.151，P=0.042）与 OSA 患者的 GBT 阳性独立相关。
未经治疗的 OSA 患者中，葡萄糖负荷后呼气 H 或 CH 升高可能并不少见。腹部肥胖和自主神经失衡功能障碍与 OSA 患者的 GBT 阳性显著相关。SIBO 可被视为 OSA 患者治疗管理的目标。
