Shen Yang-Yang, Zhu Jie, Shi Yuan, Tan Lu, Li Tao-Mei, Lei Fei, Tang Xiang-Dong
Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 Mar;54(2):304-309. doi: 10.12182/20230360213.
To explore the characteristics of patients with obstructive sleep apnea (OSA) and comorbid primary aldosteronism (PA) and to explore the relevant factors affecting plasma aldosterone concentration.
A total of 105 patients diagnosed with PA and admitted at West China Hospital, Sichuan University between January 2016 and December 2021 were retrospectively analyzed. The subjects were divided into a PA with comorbid snoring group (=20) and a PA with comorbid OSA group (=85) based on the results of polysomnography (PSG). The PA with comorbid OSA group was further divided into mild, moderate, and severe subgroups according to the apnea-hypopnea index (AHI). A total of 85 outpatients diagnosed with OSA were included as the control group. Demographic, clinical, biochemical, and PSG data were compared between the groups.
Compared with patients with only OSA, a significantly higher proportion of patients with OSA and comorbid PA had hypertension and elevated levels of systolic and diastolic blood pressure (<0.05). In addition, patients with OSA and comorbid PA had significantly increased AHI and significantly decreased mean oxygen saturation and sleep efficiency (<0.05). The more severe the OSA was, the higher levels of BMI, cholesterol, low-density lipoprotein, and uric acid the PA patients had. Linear regression analysis showed that the lowest oxygen saturation (=-0.222, =0.045) was negatively correlated with plasma aldosterone concentration.
Comorbidity with PA can aggravate the clinical manifestations of OSA, while OSA further disrupted the metabolism of lipids and uric acid in PA patients. Plasma aldosterone concentrations in patients with comorbid OSA and PA were affected by the lowest oxygen saturation level.
探讨阻塞性睡眠呼吸暂停(OSA)合并原发性醛固酮增多症(PA)患者的特征,并探究影响血浆醛固酮浓度的相关因素。
回顾性分析2016年1月至2021年12月在四川大学华西医院确诊并收治的105例PA患者。根据多导睡眠图(PSG)结果,将研究对象分为PA合并打鼾组(=20)和PA合并OSA组(=85)。PA合并OSA组根据呼吸暂停低通气指数(AHI)进一步分为轻度、中度和重度亚组。纳入85例确诊为OSA的门诊患者作为对照组。比较各组间的人口统计学、临床、生化和PSG数据。
与单纯OSA患者相比,OSA合并PA患者中高血压以及收缩压和舒张压升高的比例显著更高(<0.05)。此外,OSA合并PA患者的AHI显著增加,平均血氧饱和度和睡眠效率显著降低(<0.05)。OSA越严重,PA患者的BMI、胆固醇、低密度脂蛋白和尿酸水平越高。线性回归分析显示,最低血氧饱和度(=-0.222,=0.045)与血浆醛固酮浓度呈负相关。
合并PA可加重OSA的临床表现,而OSA会进一步扰乱PA患者的脂质和尿酸代谢。OSA合并PA患者的血浆醛固酮浓度受最低血氧饱和度水平的影响。