Association Between Endothelial Function (Assessed on Reactive Hyperemia Peripheral Arterial Tonometry) and Obstructive Sleep Apnea, Visceral Fat Accumulation, and Serum Adiponectin
Association Between Endothelial Function (Assessed on Reactive Hyperemia Peripheral Arterial Tonometry) and Obstructive Sleep Apnea, Visceral Fat Accumulation, and Serum Adiponectin
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DOI：
10.1253/circj.cj-14-1303
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发表时间：
2015-06-01
影响因子：
3.3
通讯作者：
Chin, Kazuo
中科院分区：
文献类型：
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作者：
Azuma, Masanori;Chihara, Yuichi;Chin, Kazuo
背景：内脏性肥胖、低脂联素和严重阻塞性睡眠呼吸暂停（OSA）与心血管疾病有关，但这些因素在内皮功能障碍中的相互作用尚不清楚。方法与结果：采用反应性充血指数（RHI）外周动脉血压计评价133例多导睡眠描记术后患者的内皮功能。内脏肥胖定义为计算机断层扫描上内脏脂肪面积>= 100 cm(2)。RHI与呼吸暂停低通气指数（AHI）、内脏脂肪面积、血清脂联素显著相关（r=-0.24， P=0.0055, r=-0.19， P=0.031, r=0.20， P=0.019）。伴有严重OSA的内脏型肥胖患者的RHI显著降低（AHI >= 30； P=0.042）。在多因素回归分析中，只有严重OSA仍然是RHI的独立预测因素（P=0.024, R-2=5.4%）。严重OSA患者（n=44）在持续气道正压通气（CPAP）治疗3个月后RHI显著改善（CPAP治疗前1.78 +/- 0.40 vs. CPAP治疗后2.00 +/- 0.53，P=0.013），与AHI患者相似
Background: Visceral obesity, low adiponectin, and severe obstructive sleep apnea (OSA) are associated with cardiovascular diseases, but the interactions among these factors on endothelial dysfunction are not well known.Methods and Results: Endothelial function in 133 patients after polysomnography was evaluated as reactive hyperemia index (RHI) on reactive hyperemia peripheral arterial tonometry. Visceral obesity was defined as visceral fat area >= 100 cm(2) on computed tomography. RHI was significantly correlated with apnea hypopnea index (AHI), visceral fat area, and serum adiponectin (r=-0.24, P=0.0055, r=-0.19, P=0.031, and r=0.20, P=0.019, respectively). RHI in patients with visceral obesity was significantly decreased in the presence of severe OSA (AHI >= 30; P=0.042). On multivariate regression analysis, only severe OSA remained as an independent predictive factor of RHI (P=0.024, R-2=5.4%). RHI in patients with severe OSA (n=44) was significantly improved after 3 months of continuous positive airway pressure (CPAP) treatment (1.78 +/- 0.40 before CPAP vs. 2.00 +/- 0.53 after CPAP, P=0.013), similarly to those with AHI