Can improvements in sleep quality positively affect serum adiponectin-levels in patients with obstructive sleep apnea?
Can improvements in sleep quality positively affect serum adiponectin-levels in patients with obstructive sleep apnea?
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DOI：
10.1016/j.sleep.2021.05.032
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发表时间：
2021-07-02
期刊：
影响因子：
4.8
通讯作者：
Hilmisson, Hugi
中科院分区：
文献类型：
--
作者：
Magnusdottir, Solveig;Thomas, Robert Joseph;Hilmisson, Hugi
背景资料：评估睡眠质量是否发生变化基于心肺耦合分析（CPC）的睡眠质量指数（SQI）对心血管疾病患者血清脂联素水平的影响。呼吸暂停治疗研究中心脏生物标志物评价的心电图（ECG）数据的次要分析（HeartBEAT），一项在CVD和中重度睡眠呼吸暂停患者中进行的多中心对照试验，随机分配到持续气道正压通气（CPAP）、夜间补充氧气（NSO）或健康生活方式和睡眠卫生教育（HLSE;对照组）。参与者与良好的质量ECG信号（n = 241）included.Results：改善CPC睡眠质量与血清脂联素水平的净平均改善2.69 mg/ml（p = 0.005），无论治疗开始。在控制混杂因素后，SQI单位增加与血清脂联素水平增加0.071 mg/ml（p = 0.012）和胰岛素水平降低0.197 mIU/ml（p = 0.0018）相关。同样，睡眠呼吸暂停指数（SAI）增加一个百分点与血清脂联素水平降低0.071 mg/ml（p = 0.017）和胰岛素水平升高0.218 mIU/ml（p = 0.020）相关。CPC睡眠片段（eLFCBB）增加一个百分点，预测葡萄糖水平增加0.371 mg/dl（p = 0.009），胰岛素水平增加0.284 mIU/ml（p = 0.010）。在接受CPAP治疗的患者中，将研究期间SQI改善的患者与SQI下降的患者进行比较，观察到血清脂联素水平差异为3.82 mg/ml（p = 0.025）。这种差异主要是由于SQI下降的患者血清脂联素水平降低（-3.20 mg/ml）。结论：睡眠质量的改善与较高的血清脂联素水平有关，并改善了血糖代谢的措施，这可能对代谢综合征和心血管健康产生有益的影响。(C)2021爱思唯尔有限公司版权所有。
Background: Assess if changes in sleep quality (Sleep Quality Index, SQI) based on cardiopulmonary coupling-analysis (CPC) impacts serum adiponectin-levels in patients with cardiovascular disease (CVD).Methods: Secondary analysis of electrocardiogram (ECG) data from the Heart Biomarker Evaluation in Apnea Treatment study (HeartBEAT), a multicenter, controlled trial in patients with CVD and moderate-severe sleep apnea, randomly assigned to intervention of Continuous Positive Airway Pressure (CPAP), Nocturnal Supplemental Oxygen (NSO) or Healthy Lifestyle and Sleep Hygiene Education (HLSE; control group). Participants with good-quality ECG-signal (n = 241) were included.Results: Improving CPC-sleep quality was associated with net average improvements in serum adiponectin-levels 2.69 mg/ml (p = 0.005) irrespective of therapy initiated. After controlling for con-founders, a unit increase in SQI was associated with increase in serum adiponectin-levels 0.071 mg/ml (p = 0.012) and decrease in insulin-levels 0.197 mIU/ml (p = 0.0018). Similarly, a percentage point in-crease in sleep apnea indicator (SAI) was associated with decrease in serum adiponectin-levels of 0.071 mg/ml (p = 0.017) and increase in insulin-levels of 0.218 mIU/ml (p = 0.020). A percentage point increase in CPC-sleep fragmentation (eLFCBB) had a predicted increase in glucose-levels 0.371 mg/dl (p = 0.009) and insulin-levels 0.284 mIU/ml (p = 0.010). In patients receiving CPAP-therapy, a difference in serum adiponictin levels of 3.82 mg/ml (p = 0.025) is observed comparing patients in which SQI-improved to patients that SQI-declined during the study period. The difference is mostly due to a decrease in serum adiponectin levels in patients that decline in SQI (-3.20 mg/ml).Conclusion: Improvements in sleep quality were associated with higher serum adiponectin-levels, and improved measures of glycemic metabolism which may have beneficial effects on metabolic syndrome and cardiovascular health. (C) 2021 Elsevier B.V. All rights reserved.