Circulation:睡眠呼吸暂停严重程度与多种心脏疾病风险存在性别特异性

2015-09-02 崔倩 译 MedSci原创

阻塞性睡眠呼吸暂停(OSA)的风险因素和随后的心血管疾病的发展(CV)并发症随性别不同而不同。研究人员假设OSA和高灵敏度肌钙蛋白T(hs-TnT),心脏结构和CV结果的关系会因性别而不同。睡眠心脏健康研究和社区动脉粥样硬化风险研究共包括了752名男性和893名女性,他们都没有CV疾病。所有的参与者(平均年龄62.5±5.5岁)都接受了多导睡眠监测和hs-TnT的测量。OSA的严重程度利用建立的临

阻塞性睡眠呼吸暂停(OSA)的风险因素和随后的心血管疾病的发展(CV)并发症随性别不同而不同。研究人员首先假设OSA和高灵敏度肌钙蛋白T(hs-TnT)、心脏结构和CV结果的关系会因性别而不同。

睡眠心脏健康研究和社区动脉粥样硬化风险研究共包括了752名男性和893名女性,他们都没有CV疾病。所有的参与者(平均年龄62.5±5.5岁)都接受了多导睡眠监测和hs-TnT的测量。OSA的严重程度利用建立的临床类别进行确定。研究人员对所有参与者进行了13.6±3.2年的随访,包括冠心病、心脏衰竭、CV和全因死亡率事件的随访。幸存的受试者在15.2±0.8年接受超声心动图的检查。

OSA与女性的hs-TnT独立相关(p=0.03),但在男性中不是(p=0.94)。同样地,OSA与女性的HF或死亡独立相关(p=0.01),但在男性中不是(p=0.10)。在调整了hs-TnT后该联系已不再显著(P=0.09)。在幸存的没有CV事件的参与者中,只有女性在中年时评估OSA与更高的左心室质量指数相关(P=0.001)。

OSA与CV疾病之间的关系存在着性别的具体差异。OSA,在中年时进行评估,只有在女性中与高水平的hs-TnT独立相关,而在男性中却没有这样的联系,而在男性中与OSA相关的其他合并症可能扮演更重要的角色。在13年的随访中,OSA只与女性的HF或死亡相关,而在那些没有疾病发生的参与者中,OSA只与女性的左心室肥厚独立相关。

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    2015-09-04 fengzhigu

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