An objective snoring index and its association with carotid atherosclerosis

客观打鼾指数及其与颈动脉粥样硬化的关系

• 批准号: 8224614
• 负责人: Jinyoung Kim
• 金额: $ 9.19万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-28 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8224614
• 关键词: Affect; Age; Alcohol consumption; Animal Model; Antihypertensive Agents; Apnea; Asians; Atherosclerosis; Biological Markers; Blood Pressure; Body mass index; Breathing; Cardiovascular Diseases; Cardiovascular system; Carotid Arteries; Carotid Atherosclerotic Disease; Case-Control Studies; Cerebrovascular Disorders; Chronic Disease; Cohort Studies; DNA; Data; Development; Devices; Diabetes Mellitus; Disease; Early Diagnosis; Early treatment; Elderly; Elements; Evaluation; Event; Faculty; Foundations; Frequencies; Future; Gender; Genome; Goals; Health; Home environment; Hour; Inflammatory; Intervention Studies; Knowledge; Korea; Koreans; Lead; Life Style; Lipids; Longitudinal Studies; Measurement; Measures; Mediating; Nursing Research; Nursing Schools; Obesity; Obstructive Sleep Apnea; Outcome; Oxidative Stress; Parents; Participant; Pharmaceutical Preparations; Phase; Physical Examination; Physical activity; Population; Positioning Attribute; Questionnaires; Receiver Operating Characteristics; Recruitment Activity; Reporting; Research; Research Infrastructure; Research Personnel; Risk; Risk Factors; Risk Reduction; Sampling; Sensitivity and Specificity; Severities; Sleep; Smoking; Snoring; Symptoms; Technology; Thick; Time; Training Programs; United States; Vascular Diseases; Writing; base; cardiovascular risk factor; career; career development; cerebrovascular; cohort; cost; diabetic; epidemiology study; genetic analysis; human subject; indexing; innovation; intima media; longitudinal analysis; middle age; novel; peer; prevent; programs; research study; sound; transmission process; vibration

DESCRIPTION (provided by applicant): The candidate's overall long-term goal is to become an independent investigator with a program of research on snoring and its association with cardiovascular disease and atherosclerosis. On the continuum of severity of sleep-related breathing disorders, snoring is at the mildest end of the spectrum of which obstructive sleep apnea (OSA) is at the more severe end. Although OSA has been associated with cardio/cerebrovascular disease, effects of snoring alone on health outcomes are largely unknown. In addition, most studies on snoring have used questionnaires to measure snoring, emphasizing that an objective validated measurement of snoring is needed. The goals of the proposed research are (a) to determine the objective snoring index that is optimally associated with carotid atherosclerosis, independent of potential cardiovascular confounders, in a case-control study (K99 phase) and (b) to validate the independent association in a large cohort and examine interactions among snoring, OSA, and obesity that are strongly related to carotid atherosclerosis (R00 phase). We have the opportunity to use the Korean Genome Epidemiology Study (KoGES), an ongoing cohort study of Korean middle-aged and older adults, to achieve the research goals. To date, 5,020 randomly selected participants have undergone biennial comprehensive physical examinations that include carotid intima-media thickness and other variables related to cardiovascular risk. During the K99 phase, we will conduct home-based sleep studies for 100 non-apneic snorers and 100 age-, body-mass index-, and gender-matched normal-controls from the KoGES, to measure objective snoring using a portable sleep device. Objective snoring measurement will include (a) the frequency of snoring episodes, (b) the percentage of snoring time during whole sleeping hours, and (c) snoring sound intensity. During the R00 phase, we will do sleep studies and assess snoring in a large cohort that will consist of 800 KoGES participants with different degrees of snoring. Using an existing ongoing large cohort with comprehensive data on participants' health outcomes is a low-cost and very innovative approach to achieving the ultimate goal of the proposed study. There is a substantial infrastructure and the candidate will have access to multiple other elements at no cost, such as carotid IMT, biomarkers, and DNA for future genetic analyses. Measuring snoring objectively in the home environment is methodologically innovative and will facilitate future snoring and nursing research. Given that the Asian population is growing rapidly in the United States, this study will be significant for the health of Asians in the US population To successfully conduct the proposed research and achieve overall long-term career goals, the candidate will actively participate in a training program during the K99 phase on (a) sleep- related breathing disorders, including snoring~ (b) carotid atherosclerosis measure~ (c) ambulatory technologies to objectively measure snoring~ (d) scientific writing, peer revie, and disseminating~ and (e) professional development for career advancement into a faculty position in a nursing school. PUBLIC HEALTH RELEVANCE: This study will (a) provide novel knowledge about objectively measured snoring and its effects on carotid atherosclerosis and future cardio/cerebrovascular health outcomes, (b) lay a foundation for further longitudinal evaluations, and (c) permit the development of strategies for early detection and intervention to prevent the development of cardio/cerebrovascular disease in at-risk snorers.

描述（由申请人提供）：候选人的总体长期目标是成为一名独立研究者，负责研究打鼾及其与心血管疾病和动脉粥样硬化的关系。在与睡眠相关的呼吸障碍的严重程度连续性中，打鼾属于最轻微的一端，而阻塞性睡眠呼吸暂停 (OSA) 属于最严重的一端。尽管 OSA 与心脑血管疾病有关，但打鼾对健康结果的影响在很大程度上尚不清楚。此外，大多数关于打鼾的研究都使用问卷来测量打鼾，强调需要对打鼾进行客观有效的测量。拟议研究的目标是 (a) 在病例对照研究（K99 阶段）中确定与颈动脉粥样硬化最佳相关的客观打鼾指数，独立于潜在的心血管混杂因素；(b) 在大型队列中验证独立关联，并检查与颈动脉粥样硬化密切相关的打鼾、OSA 和肥胖之间的相互作用（R0​​0 阶段）。 我们有机会利用韩国基因组流行病学研究（KoGES）来实现研究目标，这是一项正在进行的针对韩国中老年人的队列研究。迄今为止，5,020 名随机选择的参与者每两年接受一次全面体检，其中包括颈动脉内膜中层厚度以及与心血管风险相关的其他变量。在 K99 阶段，我们将对来自 KoGES 的 100 名非呼吸暂停打鼾者和 100 名年龄、体重指数和性别匹配的正常对照者进行家庭睡眠研究，以使用便携式睡眠设备测量客观打鼾情况。 客观打鼾测量包括（a）打鼾发作的频率，（b）整个睡眠时间内打鼾时间的百分比，以及（c）打鼾声音强度。在 R00 阶段，我们将在一个由 800 名具有不同打鼾程度的 KoGES 参与者组成的大型队列中进行睡眠研究并评估打鼾情况。使用现有的正在进行的大型队列以及有关参与者健康结果的全面数据是实现拟议研究的最终目标的一种低成本且非常创新的方法。 这里有大量的基础设施，候选人将可以免费获得多种其他元素，例如颈动脉 IMT、生物标记物和用于未来遗传分析的 DNA。在家庭环境中客观测量打鼾在方法上是创新的，并将促进未来的打鼾和护理研究。鉴于美国的亚裔人口正在迅速增长，这项研究对于美国人口中亚裔的健康具有重要意义。为了成功地进行拟议的研究并实现总体长期职业目标，候选人将在K99阶段积极参加关于（a）睡眠相关呼吸障碍，包括打鼾〜（b）颈动脉粥样硬化测量〜（c）客观测量打鼾的动态技术〜（d）科学写作的培训计划， 同行评审，以及传播和（e）专业发展，以促进职业发展到护理学校的教职职位。 公共健康相关性：本研究将（a）提供关于客观测量的打鼾及其对颈动脉粥样硬化和未来心脑血管健康结果的影响的新知识，（b）为进一步纵向评估奠定基础，以及（c）允许制定早期检测和干预策略，以预防高危打鼾者患上心脑血管疾病。