Zhou Yi-Fan, Chen Shu-Han, Wang Wan-Da, Chen Jia-Le, Cai Ping-Yu, Li Mei-Mei, Lin Yue-Ling, Li Wan-Qi, Huang De-Hong, Li Jun, Li Yue-Ting, Lin Hui-Li
Department of Cardiology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, People's Republic of China.
Department of Nephrology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, People's Republic of China.
Nat Sci Sleep. 2025 Jan 10;17:43-53. doi: 10.2147/NSS.S497970. eCollection 2025.
The effect of metabolic factors on cardiovascular risk in obstructive sleep apnea (OSA) is unclear. This study aimed to investigate the effect of metabolic factors on the left ventricular diastolic function in patients with OSA.
This cross-sectional study included a total of 478 patients with OSA from September 2018 to September 2023. After propensity score matching, wherein 193 patients with OSA with metabolic syndrome (MS) were 1:1 matched to patients with OSA without MS by sex and age, data from 386 patients were ultimately analyzed. Furthermore, all patients were divided into mild, moderate, and severe OSA groups according to their sleep apnea-hypopnea index (AHI). Measurements included nocturnal polysomnography, biochemical testing, and transthoracic echocardiography data.
The AHI in the MS group was higher (30.24±21.69 vs 23.19±17.65, p<0.001) and the lowest oxygen saturation at night was lower (77.67±9.23 vs 80.59±9.26, p<0.001) than those in the non-MS group. Additionally, the left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), end-diastolic ventricular septal thickness (IVST), left ventricular end-diastolic posterior wall thickness (LVPWT), left atrial internal diameter (LAD), and E peak to A peak velocity ratio (E/A) in the MS group were higher than those in the non-MS group (P<0.05). The E peak to e' peak velocity ratio (E/e') in the MS group was higher than that in the non-MS group (12.02±3.68 vs 11.13±3.12, P=0.011) and was positively correlated with the diagnosis of MS and metabolic factors (=0.115, p=0.024; =0.131, p=0.010, respectively). Patients with five metabolic factors had a significantly higher risk of E/e' elevation than patients in the non-MS group (odds ratio=4.238, p=0.007).
MS may be related to OSA severity and left ventricular diastolic dysfunction. An increase in metabolic factors may increase the risk of diastolic dysfunction. Among metabolic factors, blood pressure may be the most important.
代谢因素对阻塞性睡眠呼吸暂停（OSA）患者心血管风险的影响尚不清楚。本研究旨在探讨代谢因素对OSA患者左心室舒张功能的影响。
这项横断面研究共纳入了2018年9月至2023年9月期间的478例OSA患者。在进行倾向得分匹配后，将193例患有代谢综合征（MS）的OSA患者按性别和年龄1:1匹配至无MS的OSA患者，最终分析了386例患者的数据。此外，根据睡眠呼吸暂停低通气指数（AHI）将所有患者分为轻度、中度和重度OSA组。测量指标包括夜间多导睡眠图、生化检测和经胸超声心动图数据。
MS组的AHI高于非MS组（30.24±21.69 vs 23.19±17.65，p<0.001），夜间最低血氧饱和度低于非MS组（77.67±9.23 vs 80.59±9.26，p<0.001）。此外，MS组的左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、舒张末期室间隔厚度（IVST）、左心室舒张末期后壁厚度（LVPWT）、左心房内径（LAD）以及E峰与A峰速度比值（E/A）均高于非MS组（P<0.05）。MS组的E峰与e'峰速度比值（E/e'）高于非MS组（12.02±3.68 vs 11.13±3.12，P=0.011），且与MS诊断及代谢因素呈正相关（分别为=0.115，p=0.024；=0.131，p=0.010）。具有五种代谢因素的患者E/e'升高的风险显著高于非MS组患者（比值比=4.238，p=0.007）。
MS可能与OSA严重程度及左心室舒张功能障碍有关。代谢因素增加可能会增加舒张功能障碍的风险。在代谢因素中，血压可能最为重要。
