Serum Changes And Clinical Significance Of Far In Patients With Obstructive Sleep Apnea Hypopnea Syndrome Complicated With Coronary Heart Disease And Hypertension

Objective:obstructive sleep apnea-hypopnea syndrome（OSAHS）is a highly latent and destructive chronic hypoxic disease that is significantly associated with the occurrence and development of various diseases.Under OSAHS chronic intermittent hypoxia exposure,the risk of metabolic diseases,cardiovascular and cerebrovascular diseases,respiratory diseases and other diseases increased significantly.This study aimed to investigate the change of fibrinogen to albumin ratio（FAR）in OSAHS patients and its predictive value in OSAHS patients with coronary heart disease（CHD）and OSAHS combined with hypertension.Methods:From January 2021 to October 2022,198 subjects who attended the Department of Geriatric Respiratory Medicine of Hebei Provincial General Hospital and underwent nocturnal polysomnosomic respiratory monitoring were selected.Selected relevant indicators of subjects’sleep monitoring;Collect baseline data on participants;All blood routines,biochemical totals,coagulation function and other related indicators of all study subjects were tested.Participants were graded using the Guidelines for the diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome（2011 revised edition）as the diagnostic criteria.The differences between blood routine,biochemistry,coagulation and other related indexes and sleep breathing monitoring indicators in patients with normal control group,mild OSAHS group,moderate OSAHS group and severe OSAHS group were compared.The blood routine,biochemistry,coagulation,FAR values and other related indexes of OSAHS patients with hypertension,OSAHS combined with coronary heart disease group and OSAHS group were compared.The data analysis was carried out byχ2 test,nonparametric rank sum test,etc.The Spearman test was used for correlation analysis;Logistic regression analysis was used to analyze risk factors,make a receiver operating characteristic curve（ROC）,calculate the area under the curve（AUC）,and evaluate the efficacy of FAR in predicting CHD in OSHAS patients.Results:1.Basic clinical data:There were no differences in gender,age,smoking history,drinking history,and diabetes history between the four groups（P>0.05）.There were differences in CHD,hypertension and BMI levels between the four groups（P<0.05）.2.Comparison of blood test indexes:The levels of high-density lipoprotein,fibrinogen,SUA and FAR were statistically significant between the four groups（P<0.05）.There were no differences in leukocyte,neutrophil,D-dimer,platelets,total cholesterol,triglycerides,low-density lipoprotein,lactate dehydrogenase,fasting blood glucose,or creatinine levels between the four groups（P>0.05）.3.Correlation analysis of FAR and polysomnography indicators:Spearman correlation analysis results show that FAR value is positively correlated with AHI,ODI,TS90%,and FAR value is negatively correlated with LSp O2.The FAR value is not correlated with MSp O₂.4.Analysis of baseline data on OSAHS combined with hypertension:there were no significant differences in gender,age,smoking history,alcohol history,white blood cells,neutrophils,platelets,D-dimer,fibrinogen,albumin,FAR,fasting blood glucose,total cholesterol,triglycerides,high-density lipoprotein,low-density lipoprotein,and creatinine levels between the two groups（P>0.05）.There were significant differences in BMI,AHI and SUA levels between the two groups（P<0.05）.5.Analysis of baseline data of patients with OSAHS with CHD:there were no significant differences in levels of leukocytes,neutrophils,platelets,D-dimers,fibrinogen,albumin,total cholesterol,triglycerides,high-density lipoprotein,low-density lipoprotein,creatinine,and SUA between the two groups（P>0.05）.There were significant differences in age,BMI,fasting blood glucose,and FAR between the two groups（P<0.05）.6.Univariate logistic regression analysis of patients with CHD in OSAHS:Age（P=0.002）and FAR（P=0.008）were found to be statistically significant.7.Multivariate logistic regression analysis of CHD in OSAHS patients:In this study,the variables P<0.10:D-dimer,age,BMI,and FAR in univariate logistic regression analysis were performed for multivariate logistic regression,and the results showed that FAR was an independent risk factor for CHD in OSAHS patients（P<0.05）.8.The receiver operating characteristic curve of FAR in patients with OSAHS and CHD:According to the FAR value,the ROC curve for predicting CHD in OSAHS patients was plotted,and the results showed that the AUC of FAR was 0.643（95%CI:0.561～0.724）,the sensitivity was0.667%,the specificity was 0.590%,the Jordon index was 0.257%,and the best cut-off point was 6.665 2%（0.066 652）.Conclusion:1.FAR is correlated with OSAHS severity.The more severe the OSAHS,the higher the OSAHS.2.There was no significant difference in FAR between the hypertensive group with OSAHS and the hypertensive group without OSAHS.3.There was a significant difference between FAR,which was combined,and not in the OSAHS-pooled CHD group.FAR is elevated in patients with OSAHS and CHD,which is an independent risk factor for CHD in patients with OSAHS,and has predictive value for OSAHS combined with CHD.