Risk factors of atherosclerosis in elderly senile obstructive sleep apnea hypopnea syndrome patients with hypertension and type 2 diabetes / 中华全科医师杂志

ABSTRACT

Objective To explore the related factors of atherosclerosis in senile obstructive sleep apnea hypopnea syndrome (OSAHS) patients.Methods From May 2012 to January 2014,129 elderly hypertension and type 2 diabetes patients were recruited.According to the presence or absence of OSAHS,they were divided into OSAHS (n =60) and non-OSAHS (n =69) groups.And 30 physical examination subjects were selected as control group.The parameters of age,gender,height,weight,high sensitivity C-reactive protein (Hs-CRP),homocysteine (Hcy),triglyceride (TG),total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol (LDL-C) and intimate-media thickness of carotid artery (CIMT) were measured with ultrasonography.And their levels were compared among OSAHS,non-OSAHS and normal control groups.And the correlations were analyzed between CIMT and Hs-CRP,Hcy,TG,TC,HDL-C,LDL-C,age and body mass index (BMI).Results The levels of Hs-CRP[(3.40 ± 0.91) mg/L,(2.57 ± 1.01) mg/L],Hcy [(16.50 ± 2.89) μmol/L,(11.20 ± 2.32) μmol/L],CIMT[(1.06 ±0.14) mm,(0.93 ±0.13) mm],TG[(2.52 ± 1.40) mmol/L,(2.51 ±2.02) mmol/L],TC[(5.74 ± 1.16) mmol/L,(5.49 ± 1.09) mmol/L] and LDL-C[(3.15 ±0.47) mmol/L,(3.05 ±0.70) mmol/L] in both OSAHS and non-OSAHS groups were higher than those in normal control group [Hs-CRP(2.06 ± 1.22) mg/L,Hcy(6.04 ± 1.85) μmol/L,CIMT(0.65 ± 0.07) mm,TG(0.99±0.24) mmol/L,TC(3.63 ±0.71) mmol/L and LDL-C(2.47 ±0.27) mmol/L] (OSHAS group vs.control group,t =5.88,18.15,15.62,5.91,9.17,7.47,non-OSAHS group vs.control group,t=2.20,10.73,11.51,4.09,8.56,4.45,all P＜0.05).The levels of Hs-CRP,Hcy,CIMT and plaque score were higher in OSAHS group than those in non-OSAHS group [(1.92 ± 1.03) vs.(1.35 ± 0.97) points] (OSHAS group vs.non-OSAHS group,t =4.84,11.72,5.54,3.91,all P ＜0.05).CIMT or carotid artery plaque were related with age,BMI,TG,TC,LDL-C,Hs-CRP and Hcy in OSAHS group.Conclusions OSAHS may elevate the level of inflammatory factors and cause atherosclerosis.And the changes of CIMT,Hs-CRP and Hcy are parallel.Hcy also has important clinical significance in the progression of atherosclerosis.