Central Laboratory of Shanghai Eighth People's Hospital Affiliated to Jiangsu University, Shanghai, China.
Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Eighth People's Hospital Affiliated to Jiangsu University, Shanghai, China.
Int J Clin Pract. 2023 Feb 27;2023:5817644. doi: 10.1155/2023/5817644. eCollection 2023.
Obstructive sleep apnoea (OSA) is associated with an increased risk of cardiovascular disease, with alterations in coagulability suspected as the mediating factor. This study explored blood coagulability and breathing-related parameters during sleep in patients with OSA.
Cross-sectional observational study. . Shanghai Sixth People's Hospital. 903 patients diagnosed by standard polysomnography. The relationships between coagulation markers and OSA were evaluated using Pearson's correlation, binary logistic regression, and restricted cubic spline (RCS) analyses.
The platelet distribution width (PDW) and activated partial thromboplastin time (APTT) decreased significantly with increasing OSA severity (both < 0.001). PDW was positively associated with the apnoea-hypopnea index (AHI), oxygen desaturation index (ODI), and microarousal index (MAI) ( = 0.136, < 0.001; = 0.155, < 0.001; and = 0.091, = 0.008, respectively). APTT was negatively correlated with AHI ( = -0.128, < 0.001) and ODI ( = -0.123, = 0.001). PDW was negatively correlated with percentage of sleep time with oxygen saturation below 90%(CT90) ( = -0.092, = 0.009). The minimum arterial oxygen saturation (SaO) correlated with PDW ( = -0.098, = 0.004), APTT ( = 0.088, = 0.013), and prothrombin time (PT) ( = 0.106, = 0.0003). ODI was risk factors for PDW abnormalities (odds ratio (OR) = 1.009, = 0.009) after model adjustment. In the RCS, a nonlinear dose-effect relationship was demonstrated between OSA and the risk of PDW and APTT abnormalities.
Our study revealed nonlinear relationships between PDW and APTT, and AHI and ODI, in OSA, with AHI and ODI increasing the risk of an abnormal PDW and thus also the cardiovascular risk. This trial is registered with ChiCTR1900025714.
阻塞性睡眠呼吸暂停（OSA）与心血管疾病风险增加有关，凝血功能改变被认为是其介导因素。本研究旨在探讨 OSA 患者睡眠期间的凝血功能和呼吸相关参数。
横断面观察性研究。上海第六人民医院，903 例经标准多导睡眠图诊断为 OSA 的患者。采用 Pearson 相关分析、二元逻辑回归和限制性三次样条（RCS）分析评估凝血标志物与 OSA 的关系。
血小板分布宽度（PDW）和活化部分凝血活酶时间（APTT）随 OSA 严重程度的增加而显著降低（均<0.001）。PDW 与呼吸暂停-低通气指数（AHI）、氧减指数（ODI）和微觉醒指数（MAI）呈正相关（ = 0.136，<0.001； = 0.155，<0.001； = 0.091，=0.008）。APTT 与 AHI（ = -0.128，<0.001）和 ODI（ = -0.123，=0.001）呈负相关。PDW 与睡眠时氧饱和度低于 90%的时间百分比（CT90）呈负相关（ = -0.092，=0.009）。最低动脉血氧饱和度（SaO）与 PDW（ = -0.098，=0.004）、APTT（ = 0.088，=0.013）和凝血酶原时间（PT）（ = 0.106，=0.0003）相关。ODI 是 PDW 异常的危险因素（比值比（OR） = 1.009，=0.009），校正模型后。在 RCS 中，OSA 与 PDW 和 APTT 异常的风险之间显示出非线性剂量-效应关系。
本研究揭示了 OSA 患者中 PDW 与 AHI 和 ODI 之间以及 APTT 与 AHI 和 ODI 之间的非线性关系，AHI 和 ODI 增加了 PDW 异常的风险，从而也增加了心血管风险。该试验在中国临床试验注册中心注册，注册号为 ChiCTR1900025714。
