The prevalence of carotid atheromas seen on panoramic radiographs of patients with obstructive sleep apnea and their relation to risk factors for atherosclerosis
The prevalence of carotid atheromas seen on panoramic radiographs of patients with obstructive sleep apnea and their relation to risk factors for atherosclerosis
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DOI：
10.1016/s0278-2391(99)90065-4
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发表时间：
1999-05-01
影响因子：
1.9
通讯作者：
Littner, MR
中科院分区：
文献类型：
--
作者：
Friedlander, AH;Friedlander, IK;Littner, MR
目的：阻塞性睡眠呼吸暂停综合征（OSAS）患者中风的发生率非常高，但其病因仍不清楚。颅外颈动脉粥样硬化（动脉粥样硬化形成）被认为是一个可能的原因。由于动脉粥样硬化可以在全景X光片上识别，因此本研究比较了OSAS受试者和正常对照者的患病率，并分析了其与动脉粥样硬化危险因素的关系。54例男性受试者的全景X线片和病历（平均年龄，60.4岁）（呼吸暂停/呼吸不足指数[AHI] ≥ 15，打鼾和白天过度嗜睡史）评估动脉粥样硬化和危险因素，结果：12例OSAS患者（22%）的X线片显示动脉粥样硬化。对照组的X线片显示3.7%有动脉粥样硬化。这一发现具有统计学意义（P =.0079）。OSAS伴动脉粥样硬化形成者中2型糖尿病的患病率（12人中有7人，58%）远高于OSAS但无动脉粥样硬化形成者中糖尿病的患病率（42人中有10人，24%）。这一发现也具有统计学意义（P = 0.035）。在这两个主题和对照人群中看到的病变是相似的，位于颈部，1.5至2.5厘米，后方角的下颌骨。结论：人与OSAS更容易表现钙化动脉粥样硬化的全景X线照片比年龄匹配的对照。2型糖尿病在患有OSAS和钙化动脉粥样硬化的个体中明显更普遍。
Purpose: Persons with obstructive sleep apnea syndrome (OSAS) suffer inordinately high rates of stroke, but the cause remains in doubt. Atherosclerosis (atheroma formation) of the extracranial carotid artery has been suggested as a possible cause. Because atheromas can be recognized on panoramic radiographs, this study compared their prevalence in subjects with OSAS and normal controls and analyzed their relation to atherogenic risk factors.Patients and Methods: Panoramic radiographs and medical records of 54 male subjects (mean age, 60.4 years) with OSAS (apnea/hypopnea index [AHI] of 15 or greater and a history of snoring and excessive daytime sleepiness) were assessed for atheromas and risk factors, Age-matched controls were likewise assessed,Results: Twelve individuals (22%) with OSAS showed atheromas on their radiographs. The radiographs of the controls showed that 3.7% had atheromas. This finding was statistically significant (P =.0079). The prevalence of type 2 diabetes mellitus among individuals with OSAS and atheroma formation (7 of 12 persons, 58%) was far greater than the prevalence of diabetes (10 of 42 persons, 24%) experienced by individuals with OSAS but free of atheroma formation. This finding was also statistically significant (P =.035). The lesions seen in both the subject and control populations were similar and were located in the neck, 1.5 to 2.5 cm inferior-posterior to the angle of the mandible.Conclusions: Persons with OSAS are more likely to manifest calcified atheromas on their panoramic radiographs than age-matched controls. Type 2 diabetes is significantly more prevalent in individuals with both OSAS and calcified atheromas.