Obstructive sleep apnea and abdominal aortic calcification: Is there an association independent of comorbid risk factors?
Obstructive sleep apnea and abdominal aortic calcification: Is there an association independent of comorbid risk factors?
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DOI：
10.1016/j.atherosclerosis.2015.04.801
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发表时间：
2015-07-01
期刊：
影响因子：
5.3
通讯作者：
Chin, Kazuo
中科院分区：
文献类型：
--
作者：
Tachikawa, Ryo;Koyasu, Sho;Chin, Kazuo
背景资料：没有研究指出阻塞性睡眠呼吸暂停（OSA）和腹主动脉钙化（AAC）之间的关系，AAC是亚临床动脉粥样硬化和未来心血管事件的标志物。目的：研究1）OSA严重程度和AAC之间的关系，以及2）OSA是否可以独立于共病动脉粥样硬化危险因素影响AAC的程度。方法：390名40-70岁的参与者接受了多导睡眠图和腹部计算机断层扫描。使用改良的Agatston评分法分别量化上腹主动脉和下腹主动脉中的AAC，并将总AAC评分计算为两个评分的总和。OSA定义为无/轻度（呼吸暂停低通气指数[AHI] = 30，n = 174）。结果：AHI升高的参与者中，经年龄和体重指数（BMI）调整的对数转换总AAC评分更高（无/轻度OSA为3.4，中度OSA为3.7，重度OSA为4.2，p = 0.04）。包括年龄和BMI作为协变量的多变量线性回归分析显示，重度OSA与较低AAC和总AAC的较高评分相关（β = 0.15和0.14，p = 0.01和0.01，分别）。该协会并没有坚持额外调整后的传统动脉粥样硬化的危险因素，包括内脏脂肪，吸烟，高血压，血脂异常，和diabetes.Conclusions：严重的OSA与更大程度的AAC，这是依赖于共存的动脉粥样硬化的危险因素。共病的心脏代谢紊乱可能在很大程度上介导OSA与亚临床动脉粥样硬化的相关性。(C)2015爱思唯尔爱尔兰有限公司版权所有。
Background: No studies have addressed the relationship between obstructive sleep apnea (OSA) and abdominal aortic calcification (AAC), a marker for subclinical atherosclerosis and future cardiovascular events.Objectives: To investigate 1) the association between OSA severity and AAC, and 2) whether OSA can impact the extent of AAC independent of comorbid atherogenic risk factors.Methods: 390 participants aged 40-70 years underwent polysomnography and abdominal computed tomography. AAC was separately quantified in the upper and lower abdominal aorta using the modified Agatston scoring method, and the total AAC score was calculated as a sum of the two scores. OSA was defined as none/mild (apnea-hypopnea index [AHI] = 30, n = 174).Results: Log-transformed total AAC score adjusted for age and body mass index (BMI) was greater in participants with an elevated AHI (3.4 for none/mild OSA, 3.7 for moderate OSA, and 4.2 for severe OSA, p = 0.04). Multivariate linear regression analysis including age and BMI as covariates showed that severe OSA was associated with higher scores for the lower and total AAC (beta = 0.15 and 0.14, p = 0.01 and 0.01, respectively). The association did not persist after additionally adjusting for traditional atherogenic risk factors including visceral fat, smoking, hypertension, dyslipidemia, and diabetes.Conclusions: Severe OSA was associated with a greater extent of AAC, which was dependent on coexisting atherogenic risk factors. Comorbid cardiometabolic disorders may largely mediate the association of OSA with subclinical atherosclerosis. (C) 2015 Elsevier Ireland Ltd. All rights reserved.