Objective To invesitgate the prevalence of pulmonary thromboembolism （PTE） in hospitalized patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）from January 2004 to December 2008，and analyse its impact on the severity of OSAHS. Methods Demographic and clinical characteristics of 24 OSAHS patients complicated with PTE were analyzed. 30 OSAHS patients without PTE were served as controls. Results PTE was detected in 2.44% （31/1268） of the OSAHS patients. When compared with the OSAHS patients without PTE，the OSAHS patients with PTE had a significantly higher apnea hypopnea index （AHI） [（27.8±11.6）/h vs. （18.2±8.1）/h，P=0.038] and a lower LSpO2 （lowest saturated pulse arterial oxygen level） [（78.4±8.5）% vs. （85.2±7.9）%，P=0.035]. Both groups received continuous positive airway pressure （CPAP） ventilation. Anticoagulation and/or thrombolysis treatment were used in the OSAHS patients with PTE. Conclusions We found a higher prevalence of PTE in patients with OSAHS. Compared with those without PTE，OSAHS patients with PTE have more severe sleep apnea-hypopnea and hypoxemia in sleep. Comprehensive treatments including anticoagulation and CPAP should be used in these patients.
Obstructive sleep apnea hypopnea syndrome (OSAHS) can affect the growth and development of minors. Although the gold standard for OSAHS diagnosis is an overnight polysomnography, its clinical application is limited due to the high requirements for equipment and environmental conditions. Body shape indicators can reflect the accumulation of fat in specific parts of the body. In recent years, body shape indicators (body mass index, neck circumference, waist circumference, waist to hip ratio, waist to height ratio, neck circumference to height ratio) have been increasingly used in the evaluation of minor OSAHS. This article will review the application of the above body shape indicators in the evaluation of minor OSAHS, aiming to provide a basis for better use of these indicators in the diagnosis and treatment of minor OSAHS.
Objective To investigate the relationship between adipocyte fatty acid binding protein ( A-FABP) and obstructive sleep apnea hypopnea syndrome ( OSAHS) . Methods A total of 120 patients were recruited and underwent polysomnography. The groups were allocated according severity of OSAHS and obesity. Plasma A-FABP ( ng/mL) levels were measured by ELISA. The associations between A-FABP and AHI, BMI, LSaO2 , MSaO2 , neck collar, waist /hip ratio, insulin resistance index were analyzed. Results Plasma A-FAPB levels were significantly higher in the OSAHS group than in the non-OSAHS group of same weight, independent of age and gender. In the non-OSAHS group and the severe OSAHS group, plasma A-FABP levels of obesity persons were significantly higher than those without obesity, independent of age and gender. Plasma A-FAPB level was positively correlated with AHI, BMI, insulin resistance index, neck collar, SLT90% , and waist/hip ratio, but negatevely correlated with LSaO2 and MSaO2 in the OSAHS group. In the non-OSAHS group, plasma A-FAPB level was positively correlated with BMI and insulin resistance index. Conclusions Plasma A-FABP level is higher in patients with severe OSAHS. Plasma A-FABP level is positively correlated with BMI and insulin resistance index both in OSAHS and non-OSAHS patients.
Objective To investigate the correlation between serum level of visfatin and obesity in patients with obstructive sleep apnea hypopnea syndrome ( OSAHS) . Methods Forty-seven patients with OSAHS and 20 healthy controls were recruited in this study. Polysomnography was performed in all subjects to detect apnea-hypopnea index ( AHI) . The serumlevels of cisfatin, C-reactive protein ( CRP) , TNF-α, and IL-6 were measured by enzyme linked immunosorbent assay. The body mass inex ( BMI) was calculated.The level of cisfatin was compared between the OSAHS patients with different severity and the controls, and its relationship with the levels of AHI, BMI, CRP, TNF-α, and IL-6 was analyzed. Results The serumlevel of visfatin in the OSAHS patients was higher significantly than that in the controls ( P lt;0. 01) and increased by the severity of OSAHS. There were positive correlations between the serum level of visfatin and AHI,BMI, CRP, TNF-α, IL-6 in the OSAHS patients ( P lt;0. 05) . Conclusion The expression of visfatin may play an important role in the pathogenesis of OSAHS.
Objective To investigate the antihypertensive effects of continuous airway positive pressure( CPAP) plus antihypertensive drugs on patients with obstructive sleep apnea hypopnea syndrome ( OSAHS) and hypertension.Methods 82 OSAHS patients with hypertension were enrolled in this study. They were randomly divided into a CPAP treatment group( 44 patients, treated with antihypertensive drugs and CPAP) , and a control group( 38 patients, treated with antihypertensive drugs only) . All the patients were performed polysomnography and 24-hour blood pressure monitoring before and 12 weeks after the treatment. Results After 12 weeks treatment, except the systolic pressure in night time( nSBP) , all the parameters of 24-hour blood monitoring improved better in the CPAP group than in the control group( all P lt; 0. 05) . The blood pressure dropped to normal in 75. 0% ( 33/44) CPAP patients and in 52. 6% ( 20 /38) control patients. In the CPAP group, 8( 18. 2% ) cases were withdrawn from antihypertensive drugs, 13( 29. 5% )cases required single agents, and 9( 20. 5% ) cases required three agents to achieve blood pressure control.But in the control group, all the patients needed two or more antihypertensive agents, in which 23( 60. 6% )patients needed three agents to achieve blood pressure control. After the treatment, the patients with dipping pattern blood pressure increased from10 to 29( 22. 7% -65. 9% , P lt;0. 05) in the CPAP group, and from10to 14( 26. 3% -36. 8%, P gt;0. 05) in the control group. Conclusions Combination therapy with CPAP and antihypertensive drugs controls blood pressure better than antihypertensive medication only for OSAHS patients with hypertension with fewer types of antihypertensive agents or even withdrawal from antihypertensive medication in some patients.
Objective To investigate the possible association between serum level of hepatocyte growth factor( HGF) and obstructive sleep apnea hypopnea syndrome( OSAHS) with hypertension.Methods 58 cases of OSAHS without hypertension, 61 cases of OSAHS with hypertension, and 50 normal controls were enrolled. Serum level of HGF was measured by enzyme-linked immunosorbent assay( ELISA) , and the relationships between the serum HGF level and blood pressure( BP) , apnea hypopnea index( AHI) , lowest SaO2 ( LSaO2 ) were analyzed by linear correlation analysis. Results The serum HGF level ( pg/mL) was 761. 46 ±60. 18, 970. 87 ±60. 94, and 487. 34 ±45. 52 in the OSAHS patients without hypertention, OSAHS patients with hypertention, and normal subjects, respectively. Which was significantly higher in the OSAHSpatients than the normal subjects, and highest in the OSAHS patients with hypertension( P lt; 0. 05) . The serum HGF level was positively related to AHI( r = 0. 452, P lt;0. 05) and negatively related to LSaO2 ( r =- 0. 328, P lt;0. 05) in the OSAHS patients without hypertention, positively related to AHI, SBP, DBP( r =0. 670, P lt;0. 01; r =0. 535, P lt;0. 05; r =0. 424, P lt;0. 05) and negatively related to LSaO2 ( r = - 0. 572,P lt;0. 01) in the OSAHS patients with hypertension. Conclusions SerumHGF level increases significantly in patients with OSAHS especialy in OSAHS patients with hypertension, and positively correlates with the severity of OSAHS and hypertension.
ObjectiveTo systematically review the association between the level of plasma YKL-40 and obstructive sleep apnea hypopnea syndrome (OSAHS).MethodsWe searched PubMed, EMbase, MEDLINE, CNKI, WanFang Data, VIP database and supplemented by Google academic retrieval to collect case-control studies about the association between the level of plasma YKL-40 and OSAHS from inception to April 2017. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. And then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 5 case-control studies were included, involving 755 OSAHS patients and control population. The results of meta-analysis showed that the level of plasma YKL-40 in OSAHS patients was higher than that in control group (SMD=1.20, 95%CI 0.33 to 2.06, P=0.007). The subgroup analysis showed that the level of plasma YKL-40 in OSAHS patients from Asia was significantly higher than that in control group (SMD=1.79, 95%CI 0.83 to 2.75, P=0.000 2). The comparison between different severity of OSAHS showed that the wild-medium group had lower plasma level of YKL-40 than the severe group (SMD=–0.83, 95%CI –1.46 to –0.19, P=0.01).ConclusionYKL-40 may play an important role in the pathogenesis of OSAHS. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusions.
Objective To explore the relationship between obstructive sleep apnea hypopnea syndrome ( OSAHS) and airway hyperresponsiveness ( AHR) . Methods 197 subjects suspected for OSAHS were enrolled in the study. They were all performed overnight polysomnogram ( PSG) monitoring and lung function test. Acoording to the results of FEV1% pred, they were performed bronchial provocation test( BPT)or brochial dilation test( BDT) . The relation between apnea hypopnea index ( AHI) and the degree of airway hyperresponsiveness ( AHR, expressed as PD20 -FEV1 ) was evaluated by linear correlation analysis. Results 117 patients were diagnosed as OSAHS, in which 28 cases were complicated with AHR( 3 cases with positive BDT result, 25 cases with AHR) . In 80 non-OSAHS patients, 7 cases were complicated with AHR. Theincidence of AHR was higher in the OSAHS patients compared with the non-OSAHS patients( 23. 9% vs 8. 8% , P lt; 0. 01 ) . AHI of OSAHS patients with AHR was higher than OSAHS patients without AHR[ ( 30. 3 ±5. 1) /h vs ( 23. 7 ±2. 4) /h, P lt;0. 01] . There was a positive correlation between AHI and degree of AHR in OSAHS patients with AHR( r=0. 62, P lt;0. 05, n=25) . Conclusion OSAHS is associated with an increased risk of AHR.
Objective To study the changes of receptor activator of nuclear factor-κB ligand (RANKL, an osteoclastogenesis-promoting factor) and osteoprotegerin (OPG, the decoy receptor for RANKL), oxidative stress and bone turnover markers in obstructive sleep apnea-hypopnea syndrome (OSAHS), in order to understand the potential mechanisms underlying bone loss in OSAHS patients. Methods Ninety-eight male patients with OSAHS, confirmed by polysomnography (PSG) study, were enrolled. The patients were divided into mild-moderate groups and severe groups. Forty-two male subjects who were confirmed as not having OSAHS served as the controls. The subjects’ bone mineral density (BMD) and T-score were assessed in lumbar spine and femoral neck using dual-energy X-ray absorptiometry. Blood samples were collected from all subjects for measurement of RANKL, OPG, the bone formation marker bone-specific alkaline phosphatase (BAP), the bone resorption marker tartrate-resistant acid phosphatase-5b (TRAP-5b), total antioxidant capacity (TAOC). Twenty-eight severe OSAHS patients accepted continuous positive airway pressure (CPAP) treatment voluntarily. After 6 months, PSG was conducted, and serum RANKL, OPG, TAOC, TRAP-5b, BAP was measured after six months treatment. Results The BMD, T-score of the femoral neck and the lumbar spine were significantly lower in OSAHS patients as compared to the control group. The level of BAP was significantly decreased in the OSAHS group as compared to the control group, and there was no significant difference in TRAP-5b level between two groups. As compared with the control group, levels of OPG, TAOC and the OPG/RANKL ratio decreased significantly. None of these parameters (BMD, T-score, RANKL, OPG, TRAP-5b, BAP) showed significant difference between patients with mild-moderate and severe OSAHS group. Correlation analysis showed that the apnea hypopnea index and oxygen desaturation index were correlated with TAOC. BAP level was positively correlated with TAOC and lowest pulse oxygen saturation. The serum level of TAOC was lower in the OSAHS group after CPAP therapy, but the levels of RANKL, OPG, TRAP-5b, BAP were not different. As compared with the OSAHS group before CPAP therapy, the BMD of the femoral neck and the lumbar spine were not significant difference. Conclusions In patients with OSAHS, the oxidative stress response is enhanced, and imbalance of OPG/RANKL is shifted, which participates in the occurrence of osteoporosis. The oxidative stress injury of severe OSAHS patients was relieved after non-invasive ventilation treatment, but the effect of oxidative stress response on bone metabolism still needs further evaluation.
Objective To investigate the prevalence of obstructive sleep apnea hypopnea syndrome ( OSAHS) in patients with idiopathic pulmonary fibrosis ( IPF) and its clinical significance. Methods Sleep quality and breathing disorders were measured by polysomnography and the relationship with lung function was analyzed in 20 IPF patients. Results Thirteen of 20 subjects ( 65% ) had OSAHS as defined by an AHI ≥5 events per hour. Three subjects ( 15% ) had mild OSAHS ( AHI,5 to 20 events per hour) , and 10 subjects ( 50% ) had moderate-to-severe OSAHS ( AHI≥20 events per hour) . The sleep architecture in these patients showed a reduction in sleep efficiency, rapid eye movement ( REM) sleep and slow wave sleep, and a marked sleep fragmentation due to an increased arousal index. The AHI was negatively correlated with FVC% pred ( r =-0.672, P=0.001) and FEV1% pred ( r =-0.659, P=0.002) , and positively correlated with body mass index ( BMI) ( r=0.791, Plt;0.0001) . Conclusions OSAHS is a common comorbidity in IPF. Early treatment of OSAHS may improve quality of life and the prognosis of patients with IPF.