The Impact of Glycolipid Metabolic Disorders on Severity Stage-Specific Variation of Cardiac Autonomic Function in Obstructive Sleep Apnea: A Data-Driven Clinical Study

被引：3

作者：

Zhao, Xiaolong ^{[1
,2
,3
,4
]}

Xu, Huajun ^{[1
,2
,4
]}

Dong, Chuan ^{[3
]}

Fan, Jiangang ^{[3
]}

He, Gang ^{[3
]}

Zou, Jianyin ^{[1
,2
,4
]}

Meng, Lili ^{[1
,2
,4
]}

Zhu, Huaming ^{[1
,2
,4
]}

Su, Kaiming ^{[1
,2
,4
]}

Yang, Mingpo ^{[5
]}

Yi, Hongliang ^{[1
,2
,4
]}

Wang, Jian ^{[6
]}

Yin, Shankai ^{[1
,2
,4
]}

Guan, Jian ^{[1
,2
,4
]}

机构：

[1] Shanghai Jiao Tong Univ Affiliated Peoples Hosp 6, Dept Otolaryngol Head & Neck Surg, Shanghai, Peoples R China

[2] Shanghai Jiao Tong Univ Affiliated Peoples Hosp 6, Ctr Sleep Med, Shanghai, Peoples R China

[3] Univ Elect Sci & Technol China, Dept Otolaryngol Head & Neck Surg, Sichuan Prov Peoples Hosp, Chengdu, Peoples R China

[4] Shanghai Key Lab Sleep Disordered Breathing, Shanghai, Peoples R China

[5] Chinese Acad Sci, Shanghai Inst Biol Sci, Inst Neurosci, Shanghai, Peoples R China

[6] Dalhousie Univ, Sch Commun Sci & Disorders Physiol & Biophys, Halifax, NS, Canada

来源：

NATURE AND SCIENCE OF SLEEP | 2021年 / 13卷

基金：

中国国家自然科学基金;

关键词：

obstructive sleep apnea; autonomic nervous system; cardiac autonomic neuropathy; metabolism; heart rate variability; HEART-RATE-VARIABILITY; CARDIOVASCULAR-DISEASE; RISK; MORTALITY; DYSFUNCTION; NEUROPATHY;

D O I：

10.2147/NSS.S317201

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Cardiac autonomic dysfunction (CAD) is a common pathology in cardiovascular diseases; however, the role of glycolipid metabolic disorders in CAD development in obstructive sleep apnea (OSA) remains poorly understood. Methods: In total, 4152 patients with suspected OSA were recruited in our sleep center. Metabolic characteristics including anthropometric and glycolipid data were collected. Heart rate variability (HRV) was measured to assess the risk of CAD; its dose-response relationship with OSA severity was evaluated via restricted cubic spline (RCS) analysis. A segmented multivariate linear regression (SMLR) model was used to evaluate the roles of metabolic variables in different stages of OSA. Results: The RCS showed that CAD risk increased in a nonlinear relationship pattern with OSA severity, from slow fluctuation at earlier stages to rapid change in later stages. After integrating the clinical definition and RCS selected knots, we obtained the new four OSA severity stages. SMLR model showed that the overall value of glycolipid variables for prediction of HRV abnormalities was greater than the value of OSA variables at earlier stages, while OSA variables were more effective predictors in more severe stages. The discordance in respective relationship of HRV with metabolic and OSA variables sheds the light how metabolic disorders promoted the development of CAD in OSA, the later further in turn deteriorates cardiac function. Conclusion: These results are indicative of stage-specific involvement of glycolipid metabolic factors underlying CAD nonlinear changes in patients with OSA. Early control glycolipid disorders may help the control of CAD development in patients with OSA.

引用

页码：1347 / 1362

页数：16