Popovic R M, White D P
University of Colorado Health Sciences Center, Denver 80262, USA.
J Appl Physiol (1985). 1998 Mar;84(3):1055-62. doi: 10.1152/jappl.1998.84.3.1055.
Obstructive sleep apnea is a disorder with a strong male predominance. One possible explanation could be an effect of female hormones on pharyngeal dilator muscle activity. Therefore, we determined the level of awake genioglossus electromyogram (EMGgg) and upper airway resistance in 12 pre- and 12 postmenopausal women under basal conditions and during the application of an inspiratory resistive load (25 cmH2O . l-1 . s). In addition, a subgroup of eight postmenopausal women were studied a second time after 2 wk of combined estrogen and progesterone replacement in standard doses. Peak phasic and tonic genioglossus activity, expressed as a percentage of maximum, were highest in the luteal phase of the menstrual cycle (phasic 23.9 +/- 3.8%, tonic 10.2 +/- 1.0%), followed by the follicular phase (phasic 15.5 +/- 2.2%, tonic 7.3 +/- 0.8%), and were lowest in the postmenopausal group (phasic 11.3 +/- 1.6%, tonic of 5.0 +/- 0.6), whereas upper airway resistance did not differ. There was a weak but significant positive correlation between progesterone levels and both peak phasic (P < 0.05) and tonic (P < 0.01) EMGgg. Finally, there was a significant increase in EMGgg in the postmenopausal group restudied after hormone therapy. In conclusion, female hormones (possibly progesterone) have a substantial impact on upper airway dilator muscle activity.
阻塞性睡眠呼吸暂停是一种男性占主导的疾病。一种可能的解释是女性激素对咽部扩张肌活动的影响。因此，我们测定了12名绝经前和12名绝经后女性在基础状态下以及施加吸气阻力负荷（25 cmH₂O·l⁻¹·s）期间的清醒颏舌肌肌电图（EMGgg）水平和上气道阻力。此外，对8名绝经后女性组成的亚组在标准剂量联合雌激素和孕激素替代治疗2周后进行了第二次研究。以最大值的百分比表示的颏舌肌峰相和张力活动在月经周期的黄体期最高（相性23.9±3.8%，张力性10.2±1.0%），其次是卵泡期（相性15.5±2.2%，张力性7.3±0.8%），在绝经后组最低（相性11.3±1.6%，张力性5.0±0.6%），而上气道阻力无差异。孕激素水平与峰相（P<0.05）和张力性（P<0.01）EMGgg均呈弱但显著的正相关。最后，激素治疗后再次研究的绝经后组EMGgg有显著增加。总之，女性激素（可能是孕激素）对上气道扩张肌活动有实质性影响。
