Objective

The aim of this study was to summarize the evidence concerning the relationship between obstructive sleep apnoea syndrome (OSAS) and the risk of cardiovascular diseases (CVDs).

Methods

A systematic search was carried out using PubMed and Web of Science up to September 10, 2019. Categorical as well as linear and non-linear dose–response meta-analyses were respectively performed to evaluate the association between the severity of OSAS and the risk of CVDs. Apnoea-hypopnea index (AHI) was used as an indicator of OSAS severity.

Results

This study included 10 cohort studies targeting a total of 36,347 subjects and 3362 patients with CVDs. The pooled RRs of overall CVDs were 1.13 (95% confidence interval [CI] = 1.02–1.24) for mild versus non/normal OSAS, 1.16 (95% CI = 1.02–1.32) for moderate versus non/normal OSAS, 1.26 (95% CI = 1.15–1.39) for moderate-severe versus non/normal OSAS, and 1.41 (95% CI = 1.22–1.63) for severe versus non/normal OSAS. The linear dose–response meta-analysis showed that every 10 events/hour increment in AHI value was associated with a 9% increased risk of suffering from CVDs. The non-linear dose–response meta-analysis showed that the risk of CVDs increased continuously with the increment in AHI.

Conclusion

The present systematic review and meta-analysis provide evidence for a positive association between OSAS and the risk of CVDs, despite the severity of OSAS. The relative risk of CVDs increases continuously with the increment in AHI.

中文翻译：

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阻塞性睡眠呼吸暂停综合征与心血管疾病风险之间的关联：更新的系统评价和剂量反应荟萃分析。

客观的

本研究的目的是总结有关阻塞性睡眠呼吸暂停综合征 (OSAS) 与心血管疾病 (CVDs) 风险之间关系的证据。

方法

截至 2019 年 9 月 10 日，使用 PubMed 和 Web of Science 进行了系统搜索。分别进行了分类以及线性和非线性剂量反应荟萃分析，以评估 OSAS 的严重程度与风险之间的关联。心血管疾病。呼吸暂停-低通气指数 (AHI) 被用作 OSAS 严重程度的指标。

结果

该研究包括 10 项队列研究，针对 36,347 名受试者和 3362 名心血管疾病患者。轻度与非/正常 OSAS 总体 CVD 的汇总 RR 为 1.13（95% 置信区间 [CI] = 1.02–1.24），中度与非/正常 OSAS 为 1.16（95% CI = 1.02–1.32），1.26（95 % CI = 1.15–1.39) 中重度与非/正常 OSAS，1.41 (95% CI = 1.22–1.63) 为重度与非/正常 OSAS。线性剂量反应荟萃分析显示，AHI 值每增加 10 次事件/小时与 9% 的心血管疾病风险增加相关。非线性剂量反应荟萃分析表明，心血管疾病的风险随着 AHI 的增加而不断增加。

结论

尽管 OSAS 很严重，但目前的系统评价和荟萃分析提供了 OSAS 与 CVD 风险之间正相关的证据。心血管疾病的相对风险随着 AHI 的增加而不断增加。