Endothelial dysfunction and C-reactive protein in relation with the severity of obstructive sleep apnea syndrome
Endothelial dysfunction and C-reactive protein in relation with the severity of obstructive sleep apnea syndrome
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DOI：
10.1093/sleep/30.8.997
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发表时间：
2007-08-01
期刊：
影响因子：
5.6
通讯作者：
Ahn, Hee Jeong
中科院分区：
文献类型：
--
作者：
Chung, Seockhoon;Yoon, In-Young;Ahn, Hee Jeong
研究目的：探讨阻塞性睡眠呼吸暂停综合征（OSAS）患者的血流介导的扩张（FMD）和C反应蛋白（CRP）水平与呼吸紊乱和低氧血症的严重程度的关系。设计：受试者完成夜间多导睡眠描记后，测量肱动脉的FMD，并获得血液样本，以确定血清CRP水平。设置：首尔国立大学盆唐医院睡眠实验室。患者：九十人：结果：FMD与ODI、O2饱和度低于90%的时间百分比、平均O2饱和度、最低O2饱和度、收缩压、呼吸暂停低通气指数（AHI）、体重指数（BMI）相关。此外，CRP与体重指数、腰臀比、颈围、舒张压、平均氧饱和度和氧饱和度低于90%的时间百分比相关，但与AHI无关。多元逐步回归分析显示ODI是FMD的显著决定因素（校正R-2 = 10%，β =-0.33，P < 0.01）。此外，体重指数（β = 0.25，P < 0.05）和腰臀比（β = 0.21，P < 0.05）与CRP显著相关（校正R-2 = 12%，P <0.05），与其他因素无关。结论：ODI比AHI更能反映OSAS与FMD之间的关系。由于体重指数和腰臀比是OSAS患者血清CRP升高的危险因素，因此在预测OSAS患者心血管并发症时应考虑肥胖因素。
Study Objectives: To investigate flow-mediated dilatation (FMD) and C-reactive protein (CRP) levels in patients with obstructive sleep apnea syndrome (OSAS) in relation with the severity of respiratory disturbances and hypoxemia.Design: After subjects had completed nocturnal polysomnography, FMD was measured in the brachial artery, and blood samples were obtained to determine serum CRP levels.Setting: Sleep laboratory in Seoul National University Bundang Hospital. Patients: Ninety men: 22 normal controls, 28 subjects with mild to moderate OSAS, and 40 with severe OSAS.Measurements and Results: FMD was found to be correlated with oxygen desaturation index (ODI), percentage of time below 90% O-2 saturation, average 0 2 saturation, lowest 0 2 saturation, systolic blood pressure, apnea hypopnea index (AHI), and body mass index. In addition, CRP was correlated with body mass index, waist-to-hip ratio, neck circumference, diastolic pressure, average O-2 saturation and percentage of time below 90% O-2 saturation but not with AHI. Stepwise multiple regression showed that the ODI was a significant determinant of FMD (adjusted R-2 = 10%, beta = -0.33, P < 0.01). In addition, body mass index (beta = 0.25, P < 0.05) and waist-to-hip ratio (beta = 0.21, P < 0.05) were found to be significantly correlated with CRP (adjusted R-2 = 12%, P < 0.05), independently of other factors. There was no correlation between FMD and CRP.Conclusion: As a marker of nocturnal hypoxemia, ODI rather than AHI might better explain the relationship between OSAS and FMD. Because body mass index and waist-to-hip ratio were identified as risk factors of high serum CRP in OSAS, obesity should be considered when predicting cardiovascular complications in OSAS.