Nathan Hoeft, Kelsie M. Full, Jeffrey R Misialek, K. Lakshminarayan, Srishti Shrestha, Jennifer A Deal, P. Lutsey
{"title":"阻塞性睡眠呼吸暂停、夜间低氧血症和视网膜微血管:社区动脉粥样硬化风险研究","authors":"Nathan Hoeft, Kelsie M. Full, Jeffrey R Misialek, K. Lakshminarayan, Srishti Shrestha, Jennifer A Deal, P. Lutsey","doi":"10.1093/sleepadvances/zpae004","DOIUrl":null,"url":null,"abstract":"\n \n \n Retinal microvascular pathology (RMP) and obstructive sleep apnea (OSA) are both cardiovascular disease risk factors. Limited data exists on their interrelationship. We tested the hypotheses that OSA and nocturnal hypoxemia would be associated with retinal microvascular pathology and vessel calibers.\n \n \n \n We conducted a quasi-cross-sectional analysis of 1,625 participants in the Atherosclerosis Risk in Communities (ARIC) Sleep Heart Health Study (SHHS). Participants completed in-home polysomnography monitoring (1996-1998) and were categorized by OSA severity (apnea-hypopnea index (AHI): <5, 5-14.9, ≥15) and proportion of total sleep time with oxygen saturation <90% (T90). Retinal photography (1993-1995) was used to assess RMP and measure vascular diameters (central retinal arteriolar and venular equivalent; CRAE and CRVE). Logistic and linear models were adjusted for demographics, behaviors and BMI.\n \n \n \n Of the participants, 19% had OSA (AHI>15) and 4% had RMP. Severe OSA was not associated with RMP [OR (95% CI): 1.08 (0.49-2.38)] or CRAE in adjusted models. OSA severity showed a positive linear relationship with CRVE; adjusted mean CRVE for those with OSA was 195.8 μm compared to 193.2 μm for those without OSA (Ptrend = 0.03). T90 was strongly associated with CRVE, but not with RMP or CRAE. Adjusted mean CRVE for T90 ≥5% was 199.0 and 192.9 for T90 <1% (Ptrend <0.0001).\n \n \n \n OSA and T90 were not associated with RMP or CRAE. However, both OSA and T90 ≥5% were associated with wider venules, which may be early and indicative changes of increased inflammation and future risk of stroke and CHD.\n","PeriodicalId":21861,"journal":{"name":"SLEEP Advances","volume":"12 8","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Obstructive sleep apnea, nocturnal hypoxemia and retinal microvasculature: The Atherosclerosis Risk in Communities Study\",\"authors\":\"Nathan Hoeft, Kelsie M. Full, Jeffrey R Misialek, K. Lakshminarayan, Srishti Shrestha, Jennifer A Deal, P. Lutsey\",\"doi\":\"10.1093/sleepadvances/zpae004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n \\n Retinal microvascular pathology (RMP) and obstructive sleep apnea (OSA) are both cardiovascular disease risk factors. Limited data exists on their interrelationship. We tested the hypotheses that OSA and nocturnal hypoxemia would be associated with retinal microvascular pathology and vessel calibers.\\n \\n \\n \\n We conducted a quasi-cross-sectional analysis of 1,625 participants in the Atherosclerosis Risk in Communities (ARIC) Sleep Heart Health Study (SHHS). Participants completed in-home polysomnography monitoring (1996-1998) and were categorized by OSA severity (apnea-hypopnea index (AHI): <5, 5-14.9, ≥15) and proportion of total sleep time with oxygen saturation <90% (T90). Retinal photography (1993-1995) was used to assess RMP and measure vascular diameters (central retinal arteriolar and venular equivalent; CRAE and CRVE). Logistic and linear models were adjusted for demographics, behaviors and BMI.\\n \\n \\n \\n Of the participants, 19% had OSA (AHI>15) and 4% had RMP. Severe OSA was not associated with RMP [OR (95% CI): 1.08 (0.49-2.38)] or CRAE in adjusted models. 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引用次数: 0
摘要
视网膜微血管病变(RMP)和阻塞性睡眠呼吸暂停(OSA)都是心血管疾病的危险因素。关于它们之间相互关系的数据十分有限。我们测试了 OSA 和夜间低氧血症与视网膜微血管病变和血管口径相关的假设。 我们对1625名社区动脉粥样硬化风险(ARIC)睡眠心脏健康研究(SHHS)参与者进行了准横断面分析。参与者完成了家庭多导睡眠监测(1996-1998 年),并按 OSA 严重程度进行了分类(呼吸暂停-低通气指数(AHI):15),4% 的参与者患有 RMP。在调整模型中,严重 OSA 与 RMP [OR (95% CI):1.08 (0.49-2.38)]或 CRAE 无关。OSA 严重程度与 CRVE 呈正线性关系;OSA 患者的调整后平均 CRVE 为 195.8 μm,而非 OSA 患者为 193.2 μm(Ptrend = 0.03)。T90与CRVE密切相关,但与RMP或CRAE无关。T90≥5%的调整后平均CRVE为199.0,T90<1%的调整后平均CRVE为192.9(Ptrend<0.0001)。 OSA 和 T90 与 RMP 或 CRAE 无关。然而,OSA和T90≥5%与静脉增宽有关,这可能是炎症增加和未来中风和冠心病风险的早期和指示性变化。
Obstructive sleep apnea, nocturnal hypoxemia and retinal microvasculature: The Atherosclerosis Risk in Communities Study
Retinal microvascular pathology (RMP) and obstructive sleep apnea (OSA) are both cardiovascular disease risk factors. Limited data exists on their interrelationship. We tested the hypotheses that OSA and nocturnal hypoxemia would be associated with retinal microvascular pathology and vessel calibers.
We conducted a quasi-cross-sectional analysis of 1,625 participants in the Atherosclerosis Risk in Communities (ARIC) Sleep Heart Health Study (SHHS). Participants completed in-home polysomnography monitoring (1996-1998) and were categorized by OSA severity (apnea-hypopnea index (AHI): <5, 5-14.9, ≥15) and proportion of total sleep time with oxygen saturation <90% (T90). Retinal photography (1993-1995) was used to assess RMP and measure vascular diameters (central retinal arteriolar and venular equivalent; CRAE and CRVE). Logistic and linear models were adjusted for demographics, behaviors and BMI.
Of the participants, 19% had OSA (AHI>15) and 4% had RMP. Severe OSA was not associated with RMP [OR (95% CI): 1.08 (0.49-2.38)] or CRAE in adjusted models. OSA severity showed a positive linear relationship with CRVE; adjusted mean CRVE for those with OSA was 195.8 μm compared to 193.2 μm for those without OSA (Ptrend = 0.03). T90 was strongly associated with CRVE, but not with RMP or CRAE. Adjusted mean CRVE for T90 ≥5% was 199.0 and 192.9 for T90 <1% (Ptrend <0.0001).
OSA and T90 were not associated with RMP or CRAE. However, both OSA and T90 ≥5% were associated with wider venules, which may be early and indicative changes of increased inflammation and future risk of stroke and CHD.