BACKGROUND Obstructive sleep apnea syndrome (OSA) is currently recognized as an independent risk factor for hypertension, arrhythmia, coronary heart disease, stroke, and metabolic disorders (e.g. diabetes, dyslipidemia). In clinical practice, apnea-hypopnea index (AHI) is the marker used to classify disease severity and guide treatment. However, AHI alone does not sufficiently identify OSA patients at risk for cardiometabolic comorbidities. With this in mind, the aim of this retrospective study was to determine whether some polysomnographic parameters (e.g. apnea-hypopnea duration, sleep structure, nocturnal hypoxemia) are specifically associated with cardiometabolic comorbidities in OSA. METHODS In this retrospective study, 1717 patients suffering from moderate/severe OSA were included between 2013 and 2017. Data on demographics, comorbidities, and polysomnographic characteristics were collected and analyzed to identify factors associated with cardiometabolic complications. RESULTS The medical files of 1717 patients (68% male) were reviewed. The mean AHI was 43.1 +/- 27.7 with 57.3% of patients suffering from severe OSA, and 52% from at least one cardiovascular comorbidity (CVCo). Diabetes affected 22% of the patients and 27% exhibited dyslipidemia. Patients affected by CVCos were older, and more often women and non-smokers. These patients also had worse sleep quality, and a more marked intermittent/global nocturnal hypoxemia. With regard to diabetes, diabetics were older, more often non-smoker, non-drinker women, and were more obese. These patients also exhibited more severe OSA, especially in non-REM (NREM) sleep, worse sleep quality, and a more marked intermittent/global nocturnal hypoxemia. Dyslipidemia was more frequent in the absence of alcohol consumption, and was associated with OSA severity, decreased sleep quality, and longer AH in REM sleep. CONCLUSIONS This study identifies demographic and polysomnographic factors associated with cardiometabolic comorbidities. Patients (especially women) suffering from more severe OSA, longer sleep apneas and hypopneas, worse sleep quality, and marked intermittent/global nocturnal hypoxemia are more likely to develop cardiometabolic comorbidities. This should stimulate clinicians to obtain adequate treatment in this population.

中文翻译：

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阻塞性睡眠呼吸暂停患者的心脏代谢合并症与疾病严重程度、夜间低氧血症和睡眠质量下降有关。


背景技术阻塞性睡眠呼吸暂停综合征(OSA)目前被认为是高血压、心律失常、冠心病、中风和代谢紊乱(例如糖尿病、血脂异常)的独立危险因素。在临床实践中，呼吸暂停低通气指数（AHI）是用于对疾病严重程度进行分类和指导治疗的标志物。然而，仅 AHI 不足以识别有心脏代谢合并症风险的 OSA 患者。考虑到这一点，这项回顾性研究的目的是确定一些多导睡眠图参数（例如呼吸暂停低通气持续时间、睡眠结构、夜间低氧血症）是否与 OSA 的心脏代谢合并症有特定相关性。方法 在这项回顾性研究中，纳入了 2013 年至 2017 年间 1717 名患有中度/重度 OSA 的患者。收集并分析了人口统计学、合并症和多导睡眠图特征的数据，以确定与心脏代谢并发症相关的因素。结果 审查了 1717 名患者（68% 男性）的医疗档案。平均 AHI 为 43.1 +/- 27.7，其中 57.3% 的患者患有严重 OSA，52% 患有至少一种心血管合并症 (CVCo)。 22% 的患者患有糖尿病，27% 的患者患有血脂异常。受 CVCo 影响的患者年龄较大，其中女性和非吸烟者更为常见。这些患者的睡眠质量也较差，并且间歇性/全身性夜间低氧血症更明显。就糖尿病而言，糖尿病患者年龄较大，且多为不吸烟、不饮酒的女性，且肥胖程度更高。这些患者还表现出更严重的 OSA，特别是在非快速眼动 (NREM) 睡眠中，睡眠质量更差，以及更明显的间歇性/全身性夜间低氧血症。 在不饮酒的情况下，血脂异常更常见，并且与 OSA 严重程度、睡眠质量下降和快速眼动睡眠中较长的 AH 相关。结论 本研究确定了与心脏代谢合并症相关的人口统计学和多导睡眠图因素。患有更严重的 OSA、睡眠呼吸暂停和呼吸不足时间更长、睡眠质量更差以及明显的间歇性/全身性夜间低氧血症的患者（尤其是女性）更有可能出现心脏代谢合并症。这应该会刺激临床医生在这一人群中获得充分的治疗。