Correlation between apnea hypopnea index and arteriosclerosis in patients with obstructive sleep apnea hypopnea syndrome complicated with hypertension

doi:10.3969/j.issn.1674-8115.2022.04.011

Abstract

Abstract: Objective

·To explore the effect of apnea hypopnea index (AHI) on arterial stiffness in patients of obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with hypertension.

Methods

·The patients admitted to Ruijin Hospital,Shanghai Jiao Tong University School of Medicine, from July 2018 to December 2020 for polysomnography monitoring were enrolled, and divided into mild to moderate OSAHS group and moderate to severe OSAHS group according to AHI (5 times/h < AHI < 15 times/h or AHI≥15 times/h). Clinical and biochemical parameters were collected. 24-hour ambulate blood pressure and carotid-femoral pulse wave velocity (c-fPWV) were measured. Logistic regression analysis was performed between AHI and cardiovascular risk factors including age, body mass index (BMI), nocturnal systolic blood pressure, nocturnal diastolic blood pressure, low-density lipoprotein, fasting blood glucose, estimated glomerular filtration rate (eGFR), using of statin and hypoglycemic drugs.

Results

·A total of 365 patients were enrolled with an average age of (49.1±12.8) years. Three hundred and twenty-six (89.3%) were male and average BMI was (28.1±3.8) kg/m². BMI, c-fPWV, fasting blood glucose and glycosylated hemoglobin (HbA1c) in moderate to severe OSAHS group (n=257) were significantly higher than those in mild to moderate OSAHS group (n=108)(P<0.05), and there was a significant positive correlation between AHI and c-fPWV (R²=0.047, P<0.001). In patients of OSAHS complicated with hypertension (n=291), c-fPWV, fasting blood glucose and HbA1c in moderate to severe OSAHS group (n=216) were significantly higher than those in mild to moderate OSAHS group (n=75) (P<0.05). After adjusting for age, BMI, AHI, nocturnal systolic blood pressure, nocturnal diastolic blood pressure, low density lipoprotein, fasting blood glucose, eGFR, medication of statin and hypoglycemic drugs, the Logistic regression model showed that AHI (OR=1.032, 95% CI 1.009?1.055, P=0.006), age (OR=1.078, 95%CI 1.021?1.138, P=0.007), and nocturnal systolic blood pressure (OR=1.058, 95% CI 1.010?1.109, P=0.017) were independent risk factors for c-fPWV elevation.

Conclusion

·Elevated AHI increases the risk of arterial stiffness in the patients of OSAHS complicated with hypertension.

Key words: obstructive sleep apnea hypopnea syndrome (OSAHS), pulse wave velocity, apnea hypopnea index (AHI), arterial stiffness

CLC Number:

R563.9

TANG Biwen, BAI Yaya, HU Yueliang, CHAO Huijuan, WANG Qian, ZUO Junli. Correlation between apnea hypopnea index and arteriosclerosis in patients with obstructive sleep apnea hypopnea syndrome complicated with hypertension[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(4): 490-495.

Figures/Tables 5

TrendMD

References 19

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Indicator	Value （n=365）
Age/year	49.1±12.8
BMI/（kg‧m^-2）	28.1±3.8
Waist-hip ratio	1.0±0.1
Gender/n（%）
Male	326 （89.3）
Female	39 （10.7）
Group/n（%）
Mild to moderate OSAHS	108 （29.6）
Moderate to severe OSAHS	257 （70.4）
Smoking/n（%）	122 （33.4）
Drinking/n（%）	94 （25.8）
Diabetes/n（%）	75 （20.5）
Hypertension/n（%）	291 （79.7）

Indicator	Value （n=365）
Age/year	49.1±12.8
BMI/（kg‧m^-2）	28.1±3.8
Waist-hip ratio	1.0±0.1
Gender/n（%）
Male	326 （89.3）
Female	39 （10.7）
Group/n（%）
Mild to moderate OSAHS	108 （29.6）
Moderate to severe OSAHS	257 （70.4）
Smoking/n（%）	122 （33.4）
Drinking/n（%）	94 （25.8）
Diabetes/n（%）	75 （20.5）
Hypertension/n（%）	291 （79.7）

Indicator	Mild to moderate OSAHS group （n=108）	Moderate to severe OSAHS group （n=257）	P value
Age/year	44.6±11.8	50.9±12.8	0.000
BMI/（kg‧m^-2）	27.5±3.2	28.3±4.0	0.045
Heart rate/（beats‧min^-1）	82±12	77±14	0.001
Waist-hip ratio	0.99±0.08	0.98±0.06	0.398
c-fPWV/（m‧s^-1）	7.62±1.48	10.03±3.67	0.000
LDL-C/（mmol‧L^-1）	3.10±1.09	3.33±2.03	0.320
FPG/（mmol‧L^-1）	5.43±0.77	6.09±2.25	0.000
HbA1c/%	5.80±0.73	6.16±1.21	0.006
eGFR /［mL‧（min‧1.73m²）^-1］	95.9±16.1	91.8±16.5	0.044

Indicator	Mild to moderate OSAHS group （n=108）	Moderate to severe OSAHS group （n=257）	P value
Age/year	44.6±11.8	50.9±12.8	0.000
BMI/（kg‧m^-2）	27.5±3.2	28.3±4.0	0.045
Heart rate/（beats‧min^-1）	82±12	77±14	0.001
Waist-hip ratio	0.99±0.08	0.98±0.06	0.398
c-fPWV/（m‧s^-1）	7.62±1.48	10.03±3.67	0.000
LDL-C/（mmol‧L^-1）	3.10±1.09	3.33±2.03	0.320
FPG/（mmol‧L^-1）	5.43±0.77	6.09±2.25	0.000
HbA1c/%	5.80±0.73	6.16±1.21	0.006
eGFR /［mL‧（min‧1.73m²）^-1］	95.9±16.1	91.8±16.5	0.044

Indicator	OSAHS without hypertension （n=74）			OSAHS with hypertension （n=291）
Indicator	Mild to moderate OSAHS	Moderate to severe OSAHS	P value	Mild to moderate OSAHS	Moderate to severe OSAHS	P value
BMI/（kg‧m^-2）	26.9±4.3	27.6±4.5	0.525	27.8±2.6	28.5±3.9	0.092
Waist-hip ratio	1.0±0.1	1.0±0.1	0.991	1.0±0.1	1.0±0.1	0.860
c-fPWV/（m‧s^-1）	7.5±2.5	9.8±3.8	0.123	7.6±1.2	10.1±3.3	0.000
Day SBP/mmHg	135±19	127±12	0.166	135±14	135±15	0.918
Day DBP/mmHg	90±13	82±9	0.052	91±10	89±11	0.104
Night SBP/mmHg	123±18	118±14	0.370	128±16	128±17	0.996
Night DBP/mmHg	78±13	74.0±7.8	0.395	84±11	82±12	0.189
24 h SBP/mmHg	132±18	125±12	0.117	132±14	133±14	0.725
24 h DBP/mmHg	87±13	80±8	0.052	89±10	87±11	0.148
Uric acid/（μmol‧L^-1）	394.5±68.8	400.8±112.1	0.797	428.4±87.0	412.6±88.9	0.186
LDL-C/（mmol‧L^-1）	3.4±1.6	3.1±0.9	0.381	3.0±0.9	3.4±2.1	0.180
FPG/（mmol‧L^-1）	5.5±0.8	5.6±1.3	0.815	5.4±0.8	6.2±2.3	0.000
HbA1c/ %	5.7±0.6	5.9±1.0	0.524	5.8±0.8	6.2±1.2	0.014
eGFR/［mL‧（min‧1.73m²）^-1］	93.8±18.3	97.2±11.0	0.443	96.6±15.4	91.0±17.0	0.017
Carotid-IMT/mm	0.7±0.2	0.7±0.2	0.744	0.7±0.1	0.7±0.2	0.903