Obstructive Sleep Apnea as a Risk Factor for Cerebral White Matter Change in a Middle-Aged and Older General Population
Obstructive Sleep Apnea as a Risk Factor for Cerebral White Matter Change in a Middle-Aged and Older General Population
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DOI：
10.5665/sleep.2632
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发表时间：
2013-05-01
期刊：
影响因子：
5.6
通讯作者：
Shin, Chol
中科院分区：
文献类型：
--
作者：
Kim, Hyun;Yun, Chang-Ho;Shin, Chol
研究目的：阻塞性睡眠呼吸暂停（OSA）有助于全身性高血压的发展，高血压强烈预测白色改变（WMC）的发展。因此，阻塞性睡眠呼吸暂停综合征介导WMC是合理的。本研究的目的是确定OSA和大脑WMC之间是否存在关联关系。设计：在基于人群的研究中进行横断面分析。设置：来自韩国基因组和流行病学研究（KoGES）的韩国社区样本，他们于2011年在医疗中心参加了检查。参与者：共有503人（平均值+/-SD，年龄59.63 +/-7.48岁），这些人以前没有诊断出心血管和神经系统疾病。参与者接受了1晚的多导睡眠图检查，并被归类为无OSA（阻塞性呼吸暂停低通气指数[AHI]<5，n = 289）、轻度OSA（AHI 5 - 15，n = 161）和中重度OSA（AHI>= 15，n = 53）。脑磁共振成像（MRI）检查发现WMC 199例（39.56%）。调整协变量后的多变量logistic回归分析显示，与无OSA相比，中重度OSA与WMC的存在显著相关（比值比[OR] 2.08，95%，置信区间[CI] 1.05 - 4.13）。结论：中重度OSA是中老年人WMC的独立危险因素。因此，早期识别和治疗OSA可以降低中风和血管性痴呆的风险。
Study Objective: Obstructive sleep apnea (OSA) contributes to the development of systemic hypertension, and hypertension strongly predicts the development of white matter change (WMC). Thus, it is plausible that OSA mediates WMC. The goal of the current study is to determine whether a contextual relationship exists between OSA and cerebral WMC.Design: Cross-sectional analyses conducted in a population-based study.Setting: Korean community-based sample from the Korean Genome and Epidemiology Study (KoGES) who attended examinations in 2011 at a medical center.Participants: There were 503 individuals (mean +/- SD, age 59.63 +/- 7.48 y) who were free of previously diagnosed cardiovascular and neurologic diseases.Measurements and Results: Participants underwent 1-night polysomnography and were classified as no OSA (obstructive apnea-hypopnea index [AHI] < 5, n = 289), mild OSA (AHI 5-15, n = 161), and moderate to severe OSA (AHI >= 15, n = 53). WMC was identified with brain magnetic resonance imaging (MRI) and was found in 199 individuals (39.56%). Multivariate logistic regression analyses adjusted for covariates revealed that moderate to severe OSA was significantly associated with the presence of WMC (odds ratio [OR] 2.08, 95%, confidence interval [CI] 1.05-4.13) compared with no OSA. Additional adjustment of hypertension to the model did not alter the significance of the association (OR 2.03, 95% CI 1.02-4.05).Conclusions: Moderate to severe OSA is an independent risk factor for WMC in middle-aged and older individuals. Thus, early recognition and treatment of OSA could reduce the risk of stroke and vascular dementia.