A Prelimary Study On Clinic Evaluating Of The Severity Of Obstructive Sleep Apnea Hypopnea Syndrome

A prelimary study on the severity of obstructive sleep apnea hypopnea syndrome and the metabolic syndromeObjective:To explore the prevalence of metabolic syndrome among the obstructive sleep apnea hypopnea syndrome (OSAHS) patients of varying degrees and evaluate the potential association between the parameters of metabolic syndrome and OSAHS.Methods:Prospectively,97consecutive patients, diagnosed as OSAHS based on the over night polysomnography, divided into three groups according to the apnea hypopnea index(AHI):mild and moderate (5≤AHI<30),severe (30≤AHI <55) and profound (AHI≥55). History of Hypertension, cardiovascular or cerebrovascular disease, coronary heart disease, diabetes mellitus, dyslipidemia and systemic medication use, anthropometric data such as age, sex, height, neck, waist circumferences, systolic blood pressure, diastolic blood pressure etc were recorded. Fasting blood samples were obtained the morning after polysomnography, between08:00and09:00hours. Fasting blood glucose, total cholesterol, triglycerides, high density lipoprotein and low dengsity lipoprotein cholesterol levels were measured by the full automatic biochemical analysis system (Olympus AU5400). Diagnosis of metabolic syndrome was based on the2007guideline for the prevention and treatment for the dyslipidemia of Chinese adult. The prevalence of the metabolic syndrome and the components of its distribution in the different OSAHS groups were explored. Descriptive statistics were expressed as mean±standard deviation(sd). One sample Kolmogorov-Smirnov test was used to test the normal distribution. Independent-Samples T test was used for exploring the difference between two categorical variables. Pearson correlation was used to test the relationgship between the two categorical carables. The association between the presence of metabolic syndrome and the presence of OSAHS, adjusted for BMI, was determined using logistic regression. All analyses were performed using SPSS v17.0(Statistical Package for Social Sciences, Chicago, IL, USA). Results:The prevalence of metabolic syndrome was48.5%among the patients with OSAHS. The morbidity of metabolic syndrome among the defferent groups were:mild&moderate group (33.3%), severe group (43.3%), profound group (57.1%), increased by degrees with the ascending of AHI. There was a significant statistic difference between the OSAHS patients with or without metabolic syndrome(t=-2.39, P=0.019). There were statistic or significant statistic differences between the two groups for the anthropometric and sleep panels including abdominal circumference (t=-3.32, P=0.001),body mass index (t=-3.23, P=0.002),lowest oxygen saturation (t=2.47, P=0.015),3%oxygen desaturation index (t=-2.18, P=0.032). OSAHS patients with metabolic syndrome had significant higher blood level of fasting glucose, triglycerides and lower blood level of high density lipoprotein cholesterol than those without metabolic syndrome.Conclusion:The results of this study suggested that metabolic syndrome is a main comorbidity of OSAHS and the prevalence of metabolic syndrome increased with the severity of OSAHS. Abdominal obesity and the recurrent nocturnal intermittent hypoxemia might be the risk factor for OSAHS patients developing metabolic syndrome. Part Two:A primary clinic study on the evaluation of the severity of obstructive sleep apnea hypopnea syndromeObjective:OSAHS is a disease with many comorbidities, such as diabites, hypertension, obesity, etc. Apnea hypopnea index is widely used to evaluate the severity of OSAHS. The limit of AHI is it can only reflect the hypoxemia and it might lead to a over or insufficient treatment of OSAHS with comorbidities. The present study is a premary research on how to establish a model of clinic evaluation of OSAHS with comorbidities.Methods:Prospectively, according to the criteria,97consecutive patients, diagnosed as OSAHS based on the over night polysomnography were included in the research. They were divided into three groups according to the apnea hypopnea index(AHI):mild (5≤AHI<15),and moderate (15≤AHI<30) and severe profound(AHI≥30). Data of general demography and comorbidities were recorded. These data were evaluated with a clinic evaluating model established by us. The results were compared with the apnea hypopnea index. Chi-Square test was used for exploring the difference between two categorical variables. All data were handled by SPSS17.0(Statistical Package for Social Sciences, Chicago, IL, USA).Results:After estimated by the clinic evaluating model, among the7cases of mild group,2cases were regarded as moderate,3cases as severe. The adding score items were hypertension, dyslipidemia and daytime sleepiness. Among the12cases of moderate group,2cases were regarded as mild, while9cases as severe. The influnce factor were hypertension, dyslipidemia and abnormal glucose metabolism. Among the78cases of severe group,6cases were classified as mild,3as moderate due to the absence of comorbidity. The rest were repeatedly classified as severe, but more profound. There were a significant statistic difference between the AHI and the clinic evaluating model (P<0.05)Conclusion:It was better to assess the severity of OSAHS along with the comorbidity than simply with AHI. It can give a more effective guildline to the clinic treatment of OSAHS.