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与睡眠呼吸暂停严重程度相关的血液生物标志物的时间变化:芬兰的一项回顾性队列研究。

Temporal changes in blood biomarkers associated with sleep apnoea severity: a retrospective cohort study in Finland.

作者信息

Hellen Mira, Ruoranen Toni, Toppila-Salmi Sanna, Vasankari Tuula, Kreivi Hanna-Riikka, Mattila Tiina, Ollila Hanna M, Strausz Satu

机构信息

Orthodontics, Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland.

出版信息

BMJ Open. 2025 Feb 22;15(2):e090895. doi: 10.1136/bmjopen-2024-090895.

Abstract

INTRODUCTION

Obstructive sleep apnoea (OSA) is a common sleep disorder associated with breathing interruptions during sleep, often leading to oxygen level drops and sleep disturbances. OSA is known to impact various physiological parameters, including haematological and lipid profiles. This study aims to investigate the effect of continuous positive airway pressure (CPAP) therapy on laboratory values in patients with OSA.

METHODS

A retrospective study was conducted using data from Finland's largest hospital district, including 30 722 adult OSA patients treated between 2005 and 2020. A text search algorithm was implemented within the patient chart data to extract the apnoea-hypopnoea index (AHI) and the usage of CPAP therapy, along with identifying patients who had declined treatment. Haematological and metabolic laboratory values were collected 3 years before and after the first OSA diagnosis. Analysis of covariance was employed to compare parameter variations across severity levels, adjusted for age, sex and body mass index (BMI). T-test for repeated measurements was used to analyse the differences between data, 3 years prior and 3 years after the first OSA diagnosis.

RESULTS

The study of 30 722 OSA patients showed varying severity levels: 14.8% mild, 32.6% moderate and 52.6% severe, with an average diagnosis age of 55.0 years and a mean BMI of 32.4. The most clinically significant changes were observed in lipid profile markers, with improvements in cholesterol and low-density lipoprotein (LDL) levels (p value<0.05), measured before CPAP treatment initiation and after the treatment began. Conversely, glucose levels increased during the follow-up period. Similarly, haematocrit and haemoglobin decreased significantly after initiation of the CPAP treatment. In sex-specific analyses, significant improvements in cholesterol and LDL levels were found in both sexes. Triglyceride levels improved in male patients, in contrast with female participants, whose triglyceride levels increased during the follow-up period.

CONCLUSIONS

CPAP therapy significantly improves cholesterol and LDL levels in both sexes and reduces haematocrit and haemoglobin levels. This study highlights the systemic effects of OSA and underscores the importance of evaluating haematological and lipid profiles in OSA management.

摘要

引言

阻塞性睡眠呼吸暂停(OSA)是一种常见的睡眠障碍,与睡眠期间的呼吸中断有关,常导致血氧水平下降和睡眠紊乱。已知OSA会影响各种生理参数,包括血液学和血脂指标。本研究旨在探讨持续气道正压通气(CPAP)治疗对OSA患者实验室检查值的影响。

方法

利用芬兰最大医院区的数据进行了一项回顾性研究,纳入了2005年至2020年间接受治疗的30722例成年OSA患者。在患者病历数据中实施文本搜索算法,以提取呼吸暂停低通气指数(AHI)和CPAP治疗的使用情况,并识别拒绝治疗的患者。在首次诊断OSA之前和之后3年收集血液学和代谢实验室检查值。采用协方差分析比较不同严重程度水平下的参数变化,并对年龄、性别和体重指数(BMI)进行校正。使用重复测量t检验分析首次诊断OSA前3年和后3年数据之间的差异。

结果

对30722例OSA患者的研究显示了不同的严重程度水平:轻度占14.8%,中度占32.6%,重度占52.6%,平均诊断年龄为55.0岁,平均BMI为32.4。在血脂指标中观察到最具临床意义的变化,在开始CPAP治疗前和治疗开始后,胆固醇和低密度脂蛋白(LDL)水平有所改善(p值<0.05)。相反,随访期间血糖水平升高。同样,开始CPAP治疗后,血细胞比容和血红蛋白显著下降。在性别特异性分析中,男女的胆固醇和LDL水平均有显著改善。男性患者的甘油三酯水平有所改善,而女性参与者的甘油三酯水平在随访期间升高。

结论

CPAP治疗可显著改善男女的胆固醇和LDL水平,并降低血细胞比容和血红蛋白水平。本研究强调了OSA的全身影响,并强调了在OSA管理中评估血液学和血脂指标的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce71/11848660/02fba359becd/bmjopen-15-2-g001.jpg

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