Meta Analysis Of The Relationship And Risk Factors Between Obstructive Sleep Apnea Syndrome And Carotid Atherosclerosis

Objective: To systematically evaluate the relationship between obstructive sleep apnea syndrome(OSAS)and carotid artery disease and search for Possible risk factors for OSAS.Methods: We collected the data about the relationship between OSAS、carotid artery disease and carotid intima-media thickness(carotid intima-media thickness,CIMT)by searching the commonly used Chinese and English databases.The literature was selected from the establishment of the database to December 31,2022.Two evaluators independently selected the literature according to the inclusion and exclusion criteria and extracted the data and evaluated the study’s quality and bias risk.The Review manager 5.3 software was used to analyze the outcome metric data and perform subgroup analysis of the outcome indicators with heterogeneity in order to find the possible sources of heterogeneity.Using Stata 1 6.0 software to make sensitivity analysis to further find the heterogeneity and assess the stability of the results.The studies were determined for publication bias by making funnel plots and using Egger and Begg tests to make quantitative analysis.Results: This article included 17 studies,including 1685 subjects,1190 subjects in the case group and 495 subjects in the control group.The results of this study showed that the incidence of carotid atherosclerotic plaque in patients with OSAS was higher than that in the control group [OR=3.66,95%CI(1.85,7.23),P<0.05 ].The CIMT in the OSAS group was significantly higher than that in the control group[WMD=0.21,95%CI(0.15,0.28),P<0.05],and the CIMT is associated with OSAS severity.In OSAS group,BMI [WMD= 1.05,95%CI(0.25,1.86),P<0.05]、waist-hip ratio [WMD=0.07,95%CI(0.01,0.12),P<0.05] 、TC [WMD=0.10,95%CI(0.02,0.19),P<0.05]、IL-6 [WMD=0.75,95%CI(0.31,1.19),P<0.05] were significantly higher than those in the control group,the differences in the above results were all statistically significant.Compared to the control group,TG [WMD=0.12,95%CI(-0.01,0.25),P>0.05]、LDL [WMD=0.20,95%CI(-0.02,0.42),P>0.05]、HDL [WMD=-0.03,95%CI(-0.10,0.05),P>0.05] in the OSAS group were higher,but the differences of the above results were not statistically significant.Conclusion:(1)Patients with OSAS have a significantly higher CIMT and higher detection rate of carotid atherosclerotic plaques,and CIMT is associated with OSAS severity.Therefore,OSAS may be an independent risk factor for carotid atherosclerosis.(2)BMI、waist-hip ratio、TC、hs-CRP and IL-6 are closely related to OSAS and may be its risk factors.