C-反应蛋白改善了轻度至中度阻塞性睡眠呼吸暂停中检测高血压和胰岛素抵抗的能力:年龄影响
Slobodanka Pejovic1, Yimeng Shang2, Alexandros N Vgontzas1
1Sleep Research & Treatment Center, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA.
Journal of sleep research
|October 27, 2024
概括
C-反应蛋白 (CRP) 有效地检测轻度至中度阻塞性睡眠呼吸暂停 (mmOSA) 的年轻成年人的心脏代谢风险. 然而,CRP在患有mmOSA的老年人中没有显示出类似的效用,这表明疾病机制的年龄相关差异.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 睡眠医学 睡眠医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 与心脏代谢风险有关.
- C-反应蛋白 (CRP) 是一种与心血管疾病相关的炎症标记物.
- 在不同年龄组的轻度至中度OSA (mmOSA) 患者中评估心脏代谢风险的CRP的实用性尚未完全理解.
研究的目的:
- 评估CRP在确定MMOSA成年人高血压和胰岛素抵抗风险方面的有效性.
- 为了比较CRP在广泛的年龄范围内的实用性,包括老年人.
- 为了确定CRP是否能改善MMOSA患者心脏代谢疾病的风险预测模型.
主要方法:
- 一组216名成年人 (28-90岁) 患有mmOSA (呼吸暂停-呼吸暂停指数 [AHI] 5-30) 接受了睡眠研究,体检和血液检查.
- 测量包括血压 (BP),禁食葡萄糖,胰岛素和CRP水平.
- 统计分析评估了CRP,AHI和心脏代谢结果 (高血压,胰岛素抵抗) 之间的关联,按年龄分层 (<60岁与>60岁).
主要成果:
- 在60岁以下的成年人中,CRP水平,但不是AHI,与高血压和高血压的几率增加显著相关.
- 患有mmOSA的年轻人也显示了CRP和胰岛素耐药性 (lnHOMA) 之间的显著关联,独立于AHI.
- 在60岁以上的成年人中,无论是CRP还是AHI都没有显示出与高血压,高血压或胰岛素抵抗有显著的关联.
结论:
- CRP增强了检测心脏代谢风险,特别是高血压和胰岛素抵抗,在年轻和中年成人mmOSA.
- CRP与心脏代谢风险之间的关联似乎取决于年龄,在老年人 (>60岁) 中效用降低.
- 根据CRP的指示,炎症可能在患有OSA的年轻患者心脏代谢并发症的发病过程中发挥更直接的作用.
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