Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (6): 106-111.doi: 10.6040/j.issn.1673-3770.0.2023.170

• Clinical Study • Previous Articles     Next Articles

Metabolic markers in obstruetive sleep apnea hypopnea syndrome patients with different arousal thresholds

XING Liang, YUAN Yuqi, XIE Yushan, SU Yonglong, NIU Xiaoxin, MA Lina, WANG Zitong, LIU Haiqin, SHI Yewen, REN Xiaoyong   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi, China
  • Published:2023-12-15

PDF (PC)

79

Abstract: Objective This study aimed to investigate variations in clinical characteristics among patients with obstructive sleep apnea hypopnea syndrome(OSAHS)who exhibit different arousal thresholds and to analyze the correlation between arousal thresholds and clinical factors. Methods We selected 107 adult male patients diagnosed with OSAHS by polysomnography(PSG)from September 2018 to June 2022. The patients were categorized based on their arousal threshold scores and underwent arterial blood gas and biochemical examinations. We compared the PSG parameters, arterial blood gas, dyslipidemia, and fasting plasma glucose. Linear regression was used to estimate the association between significant variables and arousal threshold after adjusting for apnea hypopnea index(AHI). Additionally, we analyzed the correlation between arousal threshold and specific clinical factors. Results The high arousal threshold group had higher AHI, apnea index(AI), longest apnea time(LAT)and mean apnea time(MAT), oxygen desaturation index(ODI), percentage of total sleep time with oxygen saturation below 90%, total cholesterol(TC), and low-density lipoprotein cholesterol(LDL-C)compared to the low arousal threshold group. Conversely, the low arousal threshold group had higher values for the lowest oxygen saturation(LSaO2)and mean oxygen saturation(MSaO2)during sleep compared to the high arousal threshold group. However, both TC and LDL-C showed no correlation with arousal threshold after adjusting for AHI. Furthermore, the arousal threshold score was negatively correlated with AHI, AI, LAT and MAT, and positively correlated with LSaO2 and MSaO2. Conclusion Patients with OSAHS who had different arousal threshold showed changes in lipid metabolism, which may be potential biomarkers of metabolic disorders in such patients.

Key words: Obstructive sleep apnea hypopnea syndrome, Arousal threshold, Arterial blood gas, Dyslipidemia

CLC Number: 

  • R766
[1] Benjafield AV, Ayas NT, Eastwood PR, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis[J]. Lancet Respir Med, 2019, 7(8): 687-698. doi:10.1016/S2213-2600(19)30198-5
[2] Eckert DJ, White DP, Jordan AS, et al. Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets[J]. Am J Respir Crit Care Med, 2013, 188(8): 996-1004. doi:10.1164/rccm.201303-0448OC
[3] 杨晰珺, 关建. 阻塞性睡眠呼吸暂停低通气综合征与血脂紊乱关系的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 133-138. doi:10.6040/j.issn.1673-3770.0.2021.078 YANG Xijun, GUAN Jian. Research progress on the relationship between obstructive sleep apnea-hypopnea syndrome and dyslipidemia[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 133-138. doi:10.6040/j.issn.1673-3770.0.2021.078
[4] Berry RB, Gleeson K. Respiratory arousal from sleep: mechanisms and significance[J]. Sleep, 1997, 20(8): 654-675. doi:10.1093/sleep/20.8.654
[5] Chacon AR, Sicsic I, Zaw M, et al. The assessment and clinical utility of the respiratory arousal threshold in obstructive sleep-disordered breathing[J].Curr Pulmonol Rep, 2021, 10(4): 143-148. doi:10.1007/s13665-021-00282-2
[6] Edwards BA, Eckert DJ, McSharry DG, et al. Clinical predictors of the respiratory arousal threshold in patients with obstructive sleep apnea[J]. Am J Respir Crit Care Med, 2014, 190(11): 1293-1300. doi:10.1164/rccm.201404-0718OC
[7] Almendros I, Basoglu ÖK, Conde SV, et al. Metabolic dysfunction in OSA: is there something new under the Sun?[J]. J Sleep Res, 2022, 31(1): 13418. doi:10.1111/jsr.13418
[8] Li NZ, Wang J, Wang DL, et al. Correlation of sleep microstructure with daytime sleepiness and cognitive function in young and middle-aged adults with obstructive sleep apnea syndrome[J].Eur Arch Oto Rhino Laryngol, 2019, 276(12): 3525-3532. doi:10.1007/s00405-019-05529-y
[9] Labarca G, Gower J, Lamperti L, et al. Chronic intermittent hypoxia in obstructive sleep apnea: a narrative review from pathophysiological pathways to a precision clinical approach[J].Sleep Breath, 2020, 24(2): 751-760. doi:10.1007/s11325-019-01967-4
[10] Light M, McCowen K, Malhotra A, et al. Sleep apnea, metabolic disease, and the cutting edge of therapy[J]. Metabolism, 2018, 84: 94-98. doi:10.1016/j.metabol.2017.09.004
[11] 韩莹莹. 阻塞性睡眠呼吸暂停低通气综合征与亚临床动脉粥样硬化[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 126-132. doi:10.6040/j.issn.1673-3770.0.2022.011 HAN Yingying. Obstructive sleep apnea hypopnea syndrome and subclinical arteriosclerosis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 126-132. doi:10.6040/j.issn.1673-3770.0.2022.011
[12] 任涛, 唐以军, 王梅芳, 等. 阻塞性睡眠呼吸暂停低通气综合征对血糖、血脂及C反应蛋白的影响[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 53-57. doi: 10.6040/j.issn.1673-3770.0.2017.182 REN Tao, TANG Yijun, WANG Meifang, et al. Effect of obstructive sleep apnea-hypopnea syndrome on blood glucose, serum lipid, and C-reactive protein levels[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(6): 53-57. doi: 10.6040/j.issn.1673-3770.0.2017.182
[13] Eskandari D, Zou D, Grote L, et al. Independent associations between arterial bicarbonate, apnea severity and hypertension in obstructive sleep apnea[J].Respir Res, 2017, 18(1): 1-9. doi:10.1186/s12931-017-0607-9
[14] Stanek A, Bro(·overz)yna-Tkaczyk K, My sliński W. Oxidative stress markers among obstructive sleep apnea patients[J]. Oxidative Med Cell Longev, 2021, 2021: 1-8. doi:10.1155/2021/9681595
[15] Malhotra A, Ayappa I, Ayas N, et al. Metrics of sleep apnea severity: beyond the apnea-hypopnea index[J]. Sleep, 2021, 44(7): zsab030. doi:10.1093/sleep/zsab030
[16] Özd(·overI)lekcan Ç, Özdem(·overI)r T, Türkkani MH, et al. The association of body mass index values with severity and phenotype of sleep-disordered breathing[J]. Tuberk Toraks, 2019, 67(4): 265-271. doi:10.5578/tt.69057
[17] Li YR, Orr J, Jen R, et al. Is there a threshold that triggers cortical arousals in obstructive sleep apnea[J]. Sleep, 2019, 42(6): 047. doi:10.1093/sleep/zsz047
[18] Lee JJ, Sundar KM. Evaluation and management of adults with obstructive sleep apnea syndrome[J].Lung, 2021, 199(2): 87-101. doi:10.1007/s00408-021-00426-w
[19] 杜剑霞. 阻塞性睡眠呼吸暂停患者觉醒阈值的研究[D]. 天津: 天津医科大学, 2020. doi:10.27366/d.cnki.gtyku.2019.000693
[20] O'Driscoll D, Landry S, Pham J, et al. The physiological phenotype of obstructive sleep apnea differs between Caucasian and Chinese patients[J]. Sleep, 2019, 8(16):1-9. doi:10.1093/sleep/zsz186
[21] Butler MP, Emch JT, Rueschman M, et al. Apnea-hypopnea event duration predicts mortality in men and women in the sleep heart health study[J]. Am J Respir Crit Care Med, 2019, 199(7): 903-912. doi:10.1164/rccm.201804-0758oc
[22] Guan J, Yi HL, Zou JY, et al. Distinct severity stages of obstructive sleep apnoea are correlated with unique dyslipidaemia: large-scale observational study[J]. Thorax, 2016, 71(4): 347-355. doi:10.1136/thoraxjnl-2015-207403
[1] DONG Lin, WEN Silu, DENG Yuqin, TAO Zezhang. Therapeutic role of statins in allergic diseases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(1): 106-114.
[2] WANG Lei, LI Baowei, WANG Gang, LIU Hongdan, HAN Haolun, ZHANG Xiaoli, WU Wei. A preliminary study on nocturnal alkali reflux in OSAHS patients [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 75-79.
[3] YUAN Yuqi, CAO Zine, NIU Xiaoxin, XIE Yushan, SU Yonglong, ZHU Simin, ZHANG Yitong, LIU Haiqin, REN Xiaoyong, SHI Yewen. Clinical significance of peripheral blood inflammatory markers in obstructive sleep apnea hypopnea syndrome with hypertension [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 85-92.
[4] DING Longqing, LIU Yiming, CHENG Zhuo, SUN Ran, LIANG Hui. Observation on the therapeutic effect of oropharyngeal exercise on adult obstructive sleep apnea hypopnea syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 153-158.
[5] CHEN Shangli, QIN Tao, CHEN Xuan, CHEN Ruojin, TANG Zhi. Association between homocysteine concentration and the MTHFR C677T polymorphism and hypertension in patients with obstructive sleep apnea hypopnea syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(4): 126-133.
[6] WANG Nan, HUANG Jing, PEN Tao, FENG Bo. Current research on the relationship between obstructive sleep apnea hypopnea syndrome and tinnitus [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(2): 122-127.
[7] ZHANG Xiaoxue, WANG Wei, LIU Jie, XU Zhenju, QIAN Yongheng, HAN Min. The bacteriological characteristics and drug sensitivity of the oropharyngeal region in children and adults with OSAHS [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 35-40.
[8] PAN Jianyun, MO KunlanOverview,HU Yuli, LI ChaoyuGuidance. Research progress in internet medical services of CPAP use in patients with obstructive sleep apnea hypopnea syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(6): 117-122.
[9] HAN Yingying,LI Yanzhong. Obstructive sleep apnea hypopnea syndrome and subclinical arteriosclerosis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 126-132.
[10] YANG Xijun, GUAN Jian,WU Haiying. Research progress on the relationship between obstructive sleep apnea-hypopnea syndrome and dyslipidemia [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 133-138.
[11] JI Di, DENG Anchun. Meta-analysis of the effect of surgery for obstructive sleep apnea hypopnea syndrome on blood pressure [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 92-98.
[12] LI Xiao, YUAN Ying, LI Yanzhong, WANG Yan, YANG Ke, SUN Yongqiang, YU Xuemin, WANG Ning, WANG Lei. Effects of anxiety and depression on nocturnal blood pressure fluctuation in patients with obstructive sleep apnea hypopnea syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 68-71.
[13] YAN Zhigang, ZHANG Huihui, YU Dan, LIU Yan, WEN Lianji, WANG Di. Diagnosis and treatment of cognitive deficits in adult patients with obstructive sleep apnea hypopnea syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 155-161.
[14] LI Ling, WANG Chunling, ZHANG Li, LI Yanzhong.. Predictors of difficult airway in patients with obstructive sleep apnea-hypopnea syndrome during general anesthesia. [J]. J Otolaryngol Ophthalmol Shandong Univ, 2017, 31(6): 62-67.
[15] LIU Wenjun, YU Xueying, LÜ Dan, CHEN Zhenggang, ZHANG Yanqing, MEI Xubin, YANG Ke. Correlation between obstructive sleep apnea hypopnea syndrome and upper airway measurements of different genders. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(4): 54-59.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] ZHOU Bin,LI Bin . Endoscopic sinus surgery for 75 patients with chronic sinusitis and nasal polyps[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 24 -26 .
[2] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 94 -95 .
[3] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(4): 329 -330 .
[4] ZOU Jun,LU Yi,CHU Ren-yuan . Growth features of human embryonic lens epithelial cells cultured in vitro[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(5): 453 -456 .
[5] XIA Wen-qing,ZHENG Min,MAN Xiao-fei,LI Jian-ping . Manual nucleus fragmentation in senile cataracts [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(5): 467 -469 .
[6] LI Xue-chang,WANG Jin-lei,ZHANG Yu-li,DONG Wen-hui,HAN Zai-wen . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(6): 522 -524 .
[7] KANG Hong-jian,LI Xiao-hong,WANG Bao-an,ZHOU Tao . Emergency tracheotomy for patients with severe head injury[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(3): 234 -236 .
[8] YAN Rui,ZHU Lin-jie . Transplantation of limbal autograft following microsurgery for pterygium[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(3): 243 -244 .
[9] HUANG Fang,ZHU Cong-yue . Expression and significance of p21, p73 and PTEN in multiple primary cancers of the head and neck[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(5): 388 -392 .
[10] XU Hao-jie,LI Xue-zhong,CHEN Cheng-fang,WANG Xue-hai . Effect of intranasal endoscopic dacryocystorhinostomy[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(2): 132 -134 .
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd