饮食结构对于阻塞性睡眠呼吸暂停及其心脏代谢参数的影响分析

Association between dietary patternsand cardiometabolic parameters in patients with obstructive sleepapnea

目的探讨饮食结构对于阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)及其心脏代谢参数的影响。方法选取南京医科大学附属江宁医院68例OSA患者以及22例健康对照者纳入本研究,采用多导睡眠监测仪进行OSA诊断,睡眠质量由匹兹堡睡眠质量指数(pittsburgh sleep quality index,PSQI)评估。采用酶比色法测定血清总胆固醇(serum total cholesterol,TC)、高密度脂蛋白胆固醇(high-density iipopro tein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein-cholesterol,LDL-C)、甘油三酯(triglycerides,TG)和葡萄糖的浓度。饮食摄入通过24 h膳食回顾法和食物频率问卷调查法(food frequency questionnaire,FFQ)进行评估。使用有序逻辑回归模型来研究饮食习惯、心脏代谢参数与OSA严重程度的关系。结果轻度OSA吸烟者比例较高,而重度OSA的酒精摄入量最高。有序逻辑回归模型显示酒精摄入量的增加与OSA严重程度增加密切相关;HDL-C水平越高,OSA患病风险越低(OR=0.02,95%CI 0.0002~0.56)。此外膳食纤维摄入量越高,OSA严重程度越低(OR=0.84,95%CI 0.71~0.98)。结论OSA的严重程度与大量饮酒和睡眠障碍有关。重度OSA与低膳食纤维摄入明显相关。

Objective The effect of dietary patterns on obstructive sleep apnea(OSA)and its cardiometabolic parameters has rarely been reported.A balanced diet can control body weight,improve OSA,and reduce the risk of cardiovascular disease.The purpose of this study was to determine the effect of diet on OSA and its cardio-metabolic parameters.Methods This was a cross-sectional study involving 68 OSA patients and 22 subjects without OSA.Polysomnography was used to diagnose OSA.Sleep quality was assessed by the Pittsburgh Sleep Quality Index(PSQI).Serum Total Cholesterol(TC),High-Density Iipopro Tein-Cholesterol(HDL-C),Low-Density lipoprotein-Cholesterol(LDL-C),Triglycerides(TG),and glucose levels were determined using routine enzymatic methods.Dietary intake was assessed using a 24-h dietary review and Food Frequency Questionnaire(FFQ).An ordered logistic regression model was used to determine the relationship between dietary habits,cardiometabolic parameters,and OSA severity.Results vere OSA.Approximately 60%of the population was associated with sleep disorders.The ordered logistic regression model showed that the increase in alcohol intake was closely related to the increase in OSA severity.The higher the HDL-C level,the lower the risk of OSA(OR,0.02;95%CI 0.0002-0.56).In addition,the higher the intake of dietary fiber,the lower the severity of OSA(OR,0.84;95%CI 0.71-0.98).Conclusion The severity of OSA was shown to be related to heavy alcohol consumption and sleep disturbances.Severe OSA was significantly associated with low dietary fiber intake,which is of great significance for clinical dietary counseling and may also have a positive impact on the prognosis of OSA in patients with cardiovascular disease.