Sleep disorder is related to many comorbidities, such as diabetes, obesity, cardiovascular diseases, and hypertension. Because of its increasing prevalence rate, it has become a global problem that seriously threatens people’s health. Various forms of sleep disorder can cause increased insulin resistance and/or decreased sensitivity, thus affecting the occurrence, development and prognosis of diabetes. However, sleep health has not been paid attention to in recent years. Therefore, this article summarizes the findings of the correlation between sleep disorder and diabetes mellitus in recent years, by elaborating the relationship between various types of sleep disorder (including sleep apnea syndrome) and diabetes mellitus, as well as their mechanisms and intervention measures, in order to enhance the attention of clinical workers to sleep health, and to provide basis for reducing the risk of diabetes.
Objective To investigate the implication of oxidation protein product ( advanced oxidation protein product, AOPP) , an index of oxidative stress in obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods 47 patients with OSAHS and 48 normal controls were enrolled. The concentration of AOPP was measured by spextrophotometry after ameliorated, while superoxide ( SOD) , malonaldehyde ( MDA) , glutathione peroxidase ( GSH-PX) in morning blood samples were detected by Xanthine oxidase test. Results ( 1) Plasma AOPP and MDA were significantly elevated in OSAHS compared with those in control group ( both P lt;0. 01) . Plasma SOD and GSH-PX were significantly lower in OSAHS compared with those in control group ( both P lt;0. 01) . There were significant differences in the plasma AOPP, MDA, SODand GSH-PX among different severity of OSAHS ( all P lt; 0. 01) . Plasma AOPP and MDA were increased and SOD and GSH-PX were gradually decreased with the progression of OSAHS. ( 2) Plasma AOPP correlated well with MDA, SOD and GSH-PX, moreover, AOPP was positively correlated with apnea hyponea index or lowest oxygen saturation. Conclusion AOPP is an alternative index reflecting both oxidative streess and tissue injury in patients with OSAHS.
【Abstract】 Objective To study the effects of obstructive sleep apnea hypopnea syndrome ( OSAHS) on blood pressure variations, and explore the possible mechanism. Methods 84 adult patients ( mean age 50. 1 ±14. 8 years, male /female 67 /17) were recruited for polysomnography ( PSG) and ambulatory blood pressure monitoring. Four groups were identified based on apnea hyponea index ( AHI) ,ie. non-OSAHS group ( n=9) ,mild group ( n=19) , moderate group ( n=23) , and severe group ( n =33) .The blood pressure levels were compared among the four groups. Correlations between PSG indexes,variations of systolic blood pressure ( SBP) and diastolic blood pressure ( DBP) were analyzed. Results Inter-group blood pressure comparison showed significant differences in SBP and DBP( P lt;0. 05) , except forthe mild and the moderate OSAHS patients. As compared with the non-OSAHS patients, SBP for those with severe OSAHS was about 15 mm Hg higher, and DBP 10 mm Hg higher. Observation on SBP non-dipping rate indicated that, except for the mild and the moderate OSAHS patients where no significant differences were found, SBP non-dipping rate increased with the severity of OSAHS( the rates were 78. 3%, 57. 1% ,54. 5%, and 32. 6% , respectively for the four groups) , whereas DBP non-dipping rate significantly increased in the severe OSAHS patients( 54. 3% ) ( P lt;0. 05) . For the mild OSAHS patients, blood pressure was found to be correlated positively with the body mass index ( correlation coefficient for day time SBP was 0. 26, and for DBP was 0. 22) , the arousal index ( correlation coefficient for day time SBP was 0. 25, and for DBP was 0. 17) , and heart rate variation ( correlation coefficient for night time SBP was 0. 18, and for DBP was 0. 17) . For the moderate OSAHS patients, a positive correlation was also found between blood pressure and AHI ( correlation coefficient for day time SBP was 0. 31, and for DBP was 0. 22, correlation coefficient fornight time SBP was 0. 26) , and between blood pressure and the longest hypopnea time during sleep ( LH) ( correlation coefficient for night time DBP was 0. 2) . For the severe OSAHS patients, blood pressure was correlated positively with apnea index ( AI) ( correlation coefficient for day time SBP was 0. 61, and for DBP was 0. 5, correlation coefficient for night time SBP was 0. 57 and for night time DBP was 0. 48) . Conclusions OSAHS has ber impact on SBP than on DBP. DBP hypertension and SBP non-dipping are usually found in early OSAHS-affected patients. Factors affecting blood pressure differ with the severity of the OSAHS.
Obstructive sleep apnea hypopnea syndrome (OSAHS) can affect the growth and development of minors. Although the gold standard for OSAHS diagnosis is an overnight polysomnography, its clinical application is limited due to the high requirements for equipment and environmental conditions. Body shape indicators can reflect the accumulation of fat in specific parts of the body. In recent years, body shape indicators (body mass index, neck circumference, waist circumference, waist to hip ratio, waist to height ratio, neck circumference to height ratio) have been increasingly used in the evaluation of minor OSAHS. This article will review the application of the above body shape indicators in the evaluation of minor OSAHS, aiming to provide a basis for better use of these indicators in the diagnosis and treatment of minor OSAHS.
Objective To investigate the possible association between serum level of hepatocyte growth factor( HGF) and obstructive sleep apnea hypopnea syndrome( OSAHS) with hypertension.Methods 58 cases of OSAHS without hypertension, 61 cases of OSAHS with hypertension, and 50 normal controls were enrolled. Serum level of HGF was measured by enzyme-linked immunosorbent assay( ELISA) , and the relationships between the serum HGF level and blood pressure( BP) , apnea hypopnea index( AHI) , lowest SaO2 ( LSaO2 ) were analyzed by linear correlation analysis. Results The serum HGF level ( pg/mL) was 761. 46 ±60. 18, 970. 87 ±60. 94, and 487. 34 ±45. 52 in the OSAHS patients without hypertention, OSAHS patients with hypertention, and normal subjects, respectively. Which was significantly higher in the OSAHSpatients than the normal subjects, and highest in the OSAHS patients with hypertension( P lt; 0. 05) . The serum HGF level was positively related to AHI( r = 0. 452, P lt;0. 05) and negatively related to LSaO2 ( r =- 0. 328, P lt;0. 05) in the OSAHS patients without hypertention, positively related to AHI, SBP, DBP( r =0. 670, P lt;0. 01; r =0. 535, P lt;0. 05; r =0. 424, P lt;0. 05) and negatively related to LSaO2 ( r = - 0. 572,P lt;0. 01) in the OSAHS patients with hypertension. Conclusions SerumHGF level increases significantly in patients with OSAHS especialy in OSAHS patients with hypertension, and positively correlates with the severity of OSAHS and hypertension.
ObjectiveTo observe the impact of obstructive sleep apnea-hyponea syndrome (OSAHS) on the severity of pulmonary thromboembolism (PTE) and its treatment strategies. MethodsPTE patients hospitalized in our department between January 2006 and December 2012 were screened for this study, including 16 patients with OSAHS and 20 patients without OSAHS, and the difference in clinical characteristics such as arterial blood gas, apnea-hypopnea index, lowest pulse oxygen saturation (LSpO2) and treatment methods were analyzed and compared between the two groups. ResultsAs compared to PTE patients without OSAHS, the age of patients was lower[(53.4±12.1), (64.5±9.8) years; P=0.005], while body mass index[(29.3±2.2), (26.1±3.3) kg/m2, P=0.002] and smoking index (150±24, 101±18; P<0.001) were higher in PTE patients with OSAHS. Additionally, significantly lower LSpO2[(71.7±8.3), (79.4±7.1) mm Hg (1 mm Hg=0.133 kPa); P=0.005] and more lung segments (8±3, 5±2; P=0.001) were involved in PTE patients with OSAHS. In this cohort, all patients received anticoagulation and/or thrombolysis treatment, but the rate of continuous positive airway pressure (CPAP) ventilation application was significantly higher in PTE patients with OSAHS. ConclusionPTE patients with OSAHS have relatively lower age but serious condition, and both anticoagulation and CPAP should be used in the clinical treatment.
ObjectiveTo analyze the the characteristics of pulse oximetry (SpO2) curve changes in patients with obstructive sleep apnea (OSA), hypoxic parameters and to explore the difference and connection between obstructive apnea (OA) events and hypopnea (Hyp) events, evaluate the impact of different types of obstructive respiratory events on hypoxia, and provide a theoretical basis for exploration of hypoxic differences in each type of respiratory events and construction of prediction models for respiratory event types in the future. MethodsSixty patients with OSA diagnosed by polysomnography (PSG) were selected for retrospective analysis, and all respiratory events with oxygen drop in the recorded data overnight were divided into OA group (5972) according to the type of events and Hyp group (4110), recorded and scored events were exported from the PSG software as comma-separated variable (.csv) files, which were then imported and analyzed using the in-house built Matlab software. Propensity score matching was performed on the duration of respiratory events and whether they were accompanied by arousal in the two groups, and minimum oxygen saturation of events (e-minSpO2), the depth of desaturation (ΔSpO2), the duration of desaturation and resaturation (DSpO2), the duration of desaturation (d.DSpO2), duration of resaturation (r.DSpO2), duration of SpO2<90% (T90), duration of SpO2<90% during desaturation (d.T90), duration of SpO2<90% during resaturation (r.T90), area under the curve of SpO2<90% (ST90), area under the curve of SpO2<90% during desaturation (d.ST90), area under the curve of SpO2<90% during resaturation (r.ST90), oxygen desaturation rate (ODR) and oxygen resaturation rate (ORR), a total of 13 hypoxic parameters differences. ResultsVarious hypoxic parameters showed that more severe SpO2 desaturation in severe OSA patients, compared with mild and moderate OSA patients (P<0.05); There were statistically significant differences in the respiratory events duration and whether accompanied by arousal between the Hyp group and OA group (P<0.05), and the respiratory events duration and whether accompanied by arousal were significantly correlated with most hypoxic parameters; After accounting for respiratory events duration and whether accompanied by arousal by propensity score matching, compared with the Hyp group, e-minSpO2 was significantly lower in the OA group, ΔSpO2, d.DSpO2, r.DSpO2, ODR, ORR, T90, d.T90, r.T90, ST90, d.ST90, r.ST90 were significantly increased (P<0.05). ConclusionsDue to pathophysiological differences, all hypoxic parameters suggest that OA events will result in a more severe desaturation than Hyp events. Clinical assessment of OSA severity should not equate OA with Hyp events, which may cause more damage to the organism, establishing a basis for applying nocturnal SpO2 to automatically identify the type of respiratory event.
目的:探讨健康教育对高血压伴阻塞性睡眠呼吸暂停综合征（OSAS）的影响。方法:选择我院住院患者60例，随机分为二组，一组为实验组（入院后给予针对性健康教育），另一组为对照组（只给予一般健康教育）。结果:实验组3例患者病情控制快，血压、血脂、胆固醇控制良好，血氧饱和度恢复正常，与对照组相比，P＜0.05，有统计学意义。结论:加强对高血压伴OSAS患者的健康教育，将有助于改善其健康水平，提高治疗率及生活质量。
OBJECTIVE: To study the effects of jaw advancement in treating micromandibular deformity associated with obstructive sleep apnea syndrome (OSAS) by ramus osteotomy and genioplasty. METHODS: From April 1998 to February 2002, 12 patients with micromandibular deformity associated with OSAS (aged 14-36 years, 7 females and 5 males) were treated. Invert "L" shape ramus osteotomy and inverted replantation of posterior segment of ramus were performed to reconstruct the TMJ with the jaw advancement and genioplasty at the same time in 7 cases; mandibular angle osteotomy, bone grafts and genioplasty in 3 cases; and the jaw advancement by ramus sagittal osteotomy and genioplasty in 2 cases of the first branchial arch syndrome. RESULTS: The follow-up period was 6 months to 4 years. All the patients gained good appearance and had the distance of opening movement over 3.0 cm. Micromandible and facial asymmetries were corrected satisfactorily. The ratio of SaO2 was ascended from 82%-92% (preoperation) to 97%-99% (postoperation). OSAS was relieved. CONCLUSION: The jaw advancement by ramus osteotomy and genioplasty for treating micromandibular deformity associated with OSAS can correct the maxillofacial deformities and enlarge the upper airway space to relieve OSAS. This method has achieved satisfactory result.
Objective To explore the relationship between uric acid (UA) level and cardiovascular disease in patients with OSAHS and its clinical significance. Methods The electronic medical record system of the First hospital of Lanzhou University was used to collect 475 subjects who completed polysomnography (PSG) during hospitalization from January 2019 to May 2020. According to the Guidelines for the Diagnosis and Treatment of Obstructive Sleep Apnea Hypopnea Syndrome (Basic Version), the patients were divided into four group: control group [apnea-hypopnea index (AHI) <5 times/h, n=96], mild group (5≤AHI≤15 times/h, n=130), moderate group (15<AHI≤30 times/h, n=112), and severe group (AHI>30 times/h, n=137). The age, gender, body mass index (BMI), smoking history, drinking history, hypertension, diabetes mellitus, cardiovascular disease and biochemical indexes [including triglyceride, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, glucose, UA, blood urea nitrogen (BUN), serum creatinine, lactate dehydrogenase, homocysteine], PSG indexes were observed and compared among the four groups, and the differences were compared by appropriate statistical methods. Binary logistic regression model was used to evaluate the correlation between various risk factors and cardiovascular disease. Results There were statistically significant differences in age, gender, BMI, drinking history, hypertension and cardiovascular disease among the 4 groups (P<0.05). The levels of UA and BUN in mild, moderate and severe groups were higher than those in the control group, with statistical significance (P<0.05). With the increasing of OSAHS severity, the level of UA increased. There was statistical significance in the incidence of cardiovascular disease among the four groups (P<0.05), and the highest incidence of arrhythmia was found among the four groups. And the incidence of cardiovascular disease increases with the increasing of OSAHS severity. Binary Logistic regression analysis showed that the risk factors for cardiovascular disease in OSAHS patients were age, UA and BUN (P<0.05). Conclusions The occurrence of cardiovascular disease in OSAHS patients is positively correlated with the severity of OSAHS. The level of UA can be used as an independent risk factor for cardiovascular disease in OSAHS patients. Therefore, reducing the level of UA may have positive significance for the prevention and control of the prevalence and mortality of cardiovascular disease in OSAHS patients.