阻塞型睡眠呼吸中止症對血液脂肪濃度與功能所造成的影響

• Main Authors: Yi-Ching Chen, 陳羿靜
• Other Authors: Tzu-Chieh Chou
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/58ne7r

碩士 === 中國醫藥大學 === 公共衛生學系碩士班 === 104 === Obstructive Sleep Apnea is defined as the upper airway repeatedly obstructed during sleep that leads oxygen saturation concentration to decrease, caused Chronic intermittent hypoxia and dyslipidemia. Many studies and clinical trials indicates that abnormal lipid metabolism increase the risk of atherosclerosis in OSA patients. But the underlying mechanism for OSA caused by atherosclerosis have not been confirmed. HDL reverse cholesterol transport is related with anti-atherosclerosis. Research results of OSA to dyslipidemia is not consistent, the study between HDL reverse cholesterol transport and OSA is rare. In addition, the study found that patients with AHI≧60 had increased mortality and more severe clinical parameters. But studies have not been discussed on extreme severe OSA (AHI≧60) and others severity of OSA with lipid concentration, concentration ratio of lipid concentration and HDL reverse cholesterol transport dysfunction so far. Therefore, the objectives of this study are to estimate the association between OSA and dyslipidemia , concentration ratio of lipid concentration and HDL reverse cholesterol transport dysfunction, and to explore the pattern of the dyslipidemia and HDL reverse cholesterol transport function abnormalities in patients with different severity of OSA. Subjects recruit from China Medical University Sleep Center who examined by polysomnography(PSG). Depending on the detected of apnea hypopnea index(AHI) and oxygen desaturation index(ODI), the severity could be classified into normal (AHI and ODI <5), mild to moderate (5≦AHI<30; 5≦ODI<20), severe (30≦AHI<60; ODI≧20) and extreme severe (AHI≧60). Blood samples were collected and to analyze for total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), TC / HDL-C and LDL-C / HDL-C item. Moreover, HDL-C cholesterol efflux test was conducted and to compare the difference among the subjects. The results showed that the abnormal TG concentration was associated with OSA (p=0.0112).Under classified by the severity of OSA , extreme severe OSA (AHI ≧ 60) which compared to the control group significantly caused the odds ratio of abnormal HDL-C concentration is 27 (95% CI=1.142-642.852, p = 0.0411). This study also confirmed HDL cholesterol efflux ability in OSA patients is significantly reduced (Mild to moderate, β = - 3.64, p = 0.0021; severe, β = - 3.87, p = 0.0014; extreme severe, β = - 3.68, p = 0.0038). Severity of OSA showed a reverse association with HDL reverse cholesterol transport function (AHI, β= -0.03, p=0.0916; ODI, β= -0.03, p=0.0663)。. Therefore, OSA associated with the abnormal TG concentration. Extreme severe OSA is caused HDL-C concentration significantly abnormal. At the same time, OSA let HDL-C reverse cholesterol transport function significantly reduced. This shows dyslipidemia and HDL-C reverse cholesterol transport dysfunction in OSA patients is an important health problem. Patients should actively detect and treat for OSA , to reduce the risk of cardiovascular disease.