The Relationship Between Excessive Daytime Sleepiness And Metabolic Syndrome In Women With Obstructive Sleep Apnea Hypopnea Syndrome

Objective:Excessive daytime sleepiness(EDS)is a common symptom of obstructive sleep apnea hypopnea syndrome(OSAHS).Many studies have found that excessive daytime sleepiness is an independent risk factor for metabolic syndrome(MS)in male OSAHS.At present,there are few studies on female OSAHS.The purpose of this study was to explore the relationship between EDS and MS in female patients with OSAHS and to analyze the risk factors and protective factors of MS in female patients with OSAHS.Methods:A case-control study was conducted to collect the cases of female OSAHS patients admitted to Hospital from December 2016 to October 2019.The clinical data of the patients were analyzed retrospectively,including general conditions(sex,age,height,weight,smoking history,drinking history,blood pressure,epworth sleepiness scale),basic diseases(hypertension,hyperglycemia,diagnosis and treatment of abnormal lipid metabolism),laboratory results(biochemical complete set,glycosylated hemoglobin,fasting insulin),polysomnographic data((apnea hypopnea index,AHI),microarousal index and lowest oxygen saturation).According to the epworth sleepiness scale,all the subjects were divided into EDS group and non-EDS group,and the differences of clinical data between the two groups were compared.Taking the age=50 years as the node,the subjects was divided into mild OSAHS,moderate OSAHS and severe OSAHS layers according to the AHI at the age≥50years old,and mild OSAHS and moderate to severe OSAHS layers according to the AHI at the age<50 years old.In each stratification,the clinical data of the EDS group and the non-EDS group were compared.In the female group of OSAHS with MS,the difference of clinical data between the EDS group and the non-EDS group was compared.The correlation between MS and clinical data was analyzed by Spearman rank correlation analysis.Binary logistic regression was used to analyze the risk factors and protective factors of MS in female patients with OSAHS.Results:A total of 192 female cases of OSAHS were included in this study,including37 cases of EDS group and 155cases of non-EDS group,84 cases of female OSAHS with MS and 108 cases of female OSAHS without MS,and female OSAHS patients were mainly in the age group of 40～80 years old,with the largest number of patients aged 61～70 years old.After t-test,x~2test or nonparametric test,it was found that Body Mass Index(BMI),systolic blood pressure,microarousal index,lowest oxygen saturation,High Density Lipoprotein Cholesterol(HDL-C)and Epworth sleepiness scale(ESS)scores were significantly different among the groups(P<0.05).Further Spearman rank correlation analysis showed that MS was correlated with BMI,systolic blood pressure,HDL-C and lowest oxygen saturation(P<0.05),and MS was positively correlated with BMI and systolic blood pressure(rs>0),and negatively correlated with HDL-C and lowest blood oxygen saturation(rs<0).Through binary logistic regression analysis,it was found that BMI and systolic blood pressure were positively correlated with MS(OR=1.16,1.075,respectively,P<0.001),and HDL-C was negatively correlated with MS(OR=0.016,P<0.001).Conclusion:EDS is not a risk factor for MS in female patients with OSAHS.In female patients with OSAHS,BMI and systolic blood pressure are the risk factors for the occurrence of MS,and HDL-C is the protective factor for the occurrence of MS.