Obstructive sleep apnoea (OSA) is a common form of sleep disordered breathing. Untreated OSA might accelerate atherosclerosis, potentially increasing the cardiovascular disease burden in patients. The present study aimed to evaluate the association between objectively measured OSA severity and the presence of subclinical systemic atherosclerosis using noninvasive measurements, including tomographic quantification of the calcium burden. A total of 2157 participants of the Korean Genome and Epidemiology Study, who were free of structural heart disease and underwent both in-home polysomnography and chest computed tomography, were cross-sectionally analysed. Participants were divided into three groups based on the severity of OSA: no OSA (apnoea–hypopnoea index (AHI) <5 events·h−1, n=1096), mild OSA (AHI 5– <15 events·h−1, n=700) and moderate-to-severe OSA (AHI ≥15 events·h−1, n=361). Calcium deposits in the thoracic aorta and coronary arteries were measured by the Agatston score. Participants with moderate-to-severe OSA were 1.6 times (95% CI 1.18–2.15 times; p=0.002) more likely to have ascending thoracic aorta calcification (≥100 units) than those without OSA, after adjustment for cardiovascular risk factors. In addition, the association between moderate-to-severe OSA and ascending thoracic aorta calcification of subjects with higher epicardial fat volume was slightly stronger than that in patients without OSA and in the lowest epicardial fat volume tertile (OR 2.11, 95% CI 1.30–3.43). Severity of OSA in the general population was independently associated with subclinical systemic atherosclerosis. These findings highlight the potential importance of severe OSA, especially in subjects with higher epicardial fat, as a possible predictive factor for systemic atherosclerosis and cardiovascular disease. In this large population-based study, obstructive sleep apnoea was associated with greater thoracic aorta calcification as early signs of cardiovascular disease, especially in patients with higher epicardial fat volume http://bit.ly/31v1jKV

中文翻译：

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阻塞性睡眠呼吸暂停严重程度与亚临床系统性动脉粥样硬化的关系

阻塞性睡眠呼吸暂停 (OSA) 是睡眠呼吸障碍的一种常见形式。未经治疗的 OSA 可能会加速动脉粥样硬化，潜在地增加患者的心血管疾病负担。本研究旨在评估客观测量的 OSA 严重程度与使用无创测量（包括钙负荷的断层扫描量化）的亚临床系统性动脉粥样硬化之间的关联。对韩国基因组和流行病学研究的 2157 名参与者进行了横断面分析，这些参与者没有结构性心脏病并接受了家庭多导睡眠图和胸部计算机断层扫描。参与者根据 OSA 的严重程度分为三组：无 OSA（呼吸暂停-低通气指数（AHI）<5 个事件·h-1，n=1096），轻度 OSA（AHI 5-<15 个事件·h-1，n=700）和中度至重度 OSA（AHI ≥15 个事件·h-1，n=361）。通过 Agatston 评分测量胸主动脉和冠状动脉中的钙沉积。在调整心血管危险因素后，中度至重度 OSA 参与者发生升胸主动脉钙化（≥100 单位）的可能性是非 OSA 参与者的 1.6 倍（95% CI 1.18-2.15 倍；p=0.002）。此外，中度至重度 OSA 与较高心外膜脂肪量受试者的胸升主动脉钙化之间的相关性略强于无 OSA 和最低心外膜脂肪量三分位数的患者（OR 2.11，95% CI 1.30– 3.43)。一般人群中 OSA 的严重程度与亚临床系统性动脉粥样硬化独立相关。这些发现强调了严重 OSA 的潜在重要性，特别是在心外膜脂肪较高的受试者中，作为系统性动脉粥样硬化和心血管疾病的可能预测因素。在这项基于人群的大型研究中，阻塞性睡眠呼吸暂停与作为心血管疾病早期征兆的胸主动脉钙化程度增加有关，尤其是在心外膜脂肪量较高的患者中 http://bit.ly/31v1jKV