Bikov Andras, Frent Stefan, Reisz Daniela, Negru Alina, Gaita Laura, Breban Schwarzkopf Daniel, Mihaicuta Stefan
North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Division of Immunology, Immunity to Infection and Respiratory Medicine, University of Manchester, Manchester, UK.
Nat Sci Sleep. 2022 Jul 27;14:1333-1340. doi: 10.2147/NSS.S361318. eCollection 2022.
Obstructive sleep apnoea (OSA) is a recognised risk factor for cardiovascular disease. However, it is difficult to evaluate the risk of cardiovascular disease in patients with OSA due to multiple shared risk factors. Composite lipid indices, such as atherogenic index of plasma (AIP), visceral adiposity index (VAI) and lipid accumulation product (LAP) have been shown to predict cardiovascular disease better than their individual lipid components. This study aimed to evaluate these indices in patients with OSA.
Six hundred sixty-seven (667) patients with OSA and 139 non-OSA control volunteers participated in the study. Fasting serum triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C) levels were measured, and AIP, LAP and VAI were calculated following cardiorespiratory polygraphy. The relationship between lipid parameters, OSA and its comorbidities was evaluated using receiver operating curve (ROC) analysis.
We found a significant difference in all lipid parameters between OSA patients and controls. Comparing ROCs, LAP was significantly more strongly associated with OSA compared to all the other parameters. The optimal cut-off value for LAP to detect OSA was 76.4, with a sensitivity of 63% and a specificity of 76%. In addition, LAP was the best parameter to predict hypertension and diabetes in patients with OSA, and it was predictive for ischaemic heart disease together with HDL-C.
Our results support the use of LAP in clinical practice when evaluating cardiovascular risk in patients with OSA. However, the optimal cut-off value should be determined in large-scale follow-up studies.
阻塞性睡眠呼吸暂停（OSA）是公认的心血管疾病风险因素。然而，由于存在多种共同的风险因素，评估OSA患者的心血管疾病风险具有一定难度。复合脂质指标，如血浆致动脉粥样硬化指数（AIP）、内脏脂肪指数（VAI）和脂质蓄积产物（LAP），已被证明比其单个脂质成分能更好地预测心血管疾病。本研究旨在评估OSA患者的这些指标。
667例OSA患者和139名非OSA对照志愿者参与了本研究。测量空腹血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇（HDL-C）水平，并在进行心肺多导睡眠监测后计算AIP、LAP和VAI。使用受试者工作特征曲线（ROC）分析评估脂质参数、OSA及其合并症之间的关系。
我们发现OSA患者与对照组之间所有脂质参数均存在显著差异。比较ROC曲线，与所有其他参数相比，LAP与OSA的相关性显著更强。LAP检测OSA的最佳截断值为76.4，灵敏度为63%，特异度为76%。此外，LAP是预测OSA患者高血压和糖尿病的最佳参数，并且它与HDL-C一起可预测缺血性心脏病。
我们的结果支持在临床实践中使用LAP评估OSA患者的心血管风险。然而，最佳截断值应在大规模随访研究中确定。
