Jennum P, Schultz-Larsen K, Christensen N J
Department of Internal Medicine C, Glostrup Hospital, University of Copenhagen, Denmark.
Eur J Epidemiol. 1996 Jun;12(3):285-90. doi: 10.1007/BF00145418.
A number of studies have demonstrated an association between habitual snoring and ischemic heart disease like angina pectoris, myocardial infarction and ischemic changes on the electrocardiography (ECG). Control for the influence of potential confounders has been inadequate. To further elucidate the issue we examined the association between self-assessed snoring and the relation to atherosclerotic manifestations. 804 70-year-old males and females were classified according to snoring habits. Alcohol and tobacco consumption, blood pressure, body mass index, social group, plasma lipids (triglycerides, cholesterol, high density lipoprotein), fasting blood glucose, glucose tolerance test, plasma epinephrine and norepinephrine were determined. Presence of angina pectoris, claudication intermittens, use of nitroglycerine were questioned, a resting ECG and a distal arterial pressure by use of doppler technique in the lower limbs were determined. Distal atherosclerotic manifestations was defined as complaints of claudication intermittens, pulselessness in one or more foot arteries or a foot/arm systolic pressure ratio < 0.90. ECG changes were classified in accordance to standard criteria (Minnesota codes) into positive ECG signs (Q/OS waves, S-T depressions, T-wave inversion or flattering or left bundle branch block) and definitive myocardial infarction. Snoring showed a weak positive correlation to positive ECG signs and definitive myocardial infarction, but after adjustments for the above confounders, no association was found between snoring and atherosclerotic manifestations. We conclude that, in a 70-year-old population, self-reported snoring is not associated with atherosclerotic manifestations.
多项研究表明,习惯性打鼾与缺血性心脏病(如心绞痛、心肌梗死以及心电图(ECG)上的缺血性改变)之间存在关联。对潜在混杂因素影响的控制并不充分。为了进一步阐明这一问题,我们研究了自我评估的打鼾情况与动脉粥样硬化表现之间的关系。根据打鼾习惯对804名70岁的男性和女性进行了分类。测定了酒精和烟草消费量、血压、体重指数、社会阶层、血脂(甘油三酯、胆固醇、高密度脂蛋白)、空腹血糖、葡萄糖耐量试验、血浆肾上腺素和去甲肾上腺素。询问了是否存在心绞痛、间歇性跛行、是否使用硝酸甘油,测定了静息心电图以及使用多普勒技术测定下肢远端动脉压。远端动脉粥样硬化表现定义为间歇性跛行、一条或多条足部动脉无脉或足/臂收缩压比<0.90。根据标准标准(明尼苏达编码)将心电图改变分为阳性心电图体征(Q/OS波、S-T段压低、T波倒置或低平或左束支传导阻滞)和明确的心肌梗死。打鼾与阳性心电图体征和明确的心肌梗死呈弱正相关,但在对上述混杂因素进行调整后,未发现打鼾与动脉粥样硬化表现之间存在关联。我们得出结论,在70岁的人群中,自我报告的打鼾与动脉粥样硬化表现无关。