Causal role of immune cells in obstructive sleep apnea hypopnea syndrome:Mendelian randomization study

BACKGROUND Despite being one of the most prevalent sleep disorders,obstructive sleep apnea hypoventilation syndrome(OSAHS)has limited information on its immunologic foundation.The immunological underpinnings of certain major psychiatric diseases have been uncovered in recent years thanks to the extensive use of genome-wide association studies(GWAS)and genotyping techniques using highdensity genetic markers(e.g.,SNP or CNVs).But this tactic hasn't yet been applied to OSAHS.Using a Mendelian randomization analysis,we analyzed the causal link between immune cells and the illness in order to comprehend the immunological bases of OSAHS.AIM To investigate the immune cells'association with OSAHS via genetic methods,guiding future clinical research.METHODS A comprehensive two-sample mendelian randomization study was conducted to investigate the causal relationship between immune cell characteristics and OSAHS.Summary statistics for each immune cell feature were obtained from the GWAS catalog.Information on 731 immune cell properties,such as morphologic parameters,median fluorescence intensity,absolute cellular,and relative cellular,was compiled using publicly available genetic databases.The results'robustness,heterogeneity,and horizontal pleiotropy were confirmed using extensive sensitivity examination.RESULTS Following false discovery rate(FDR)correction,no statistically significant effect of OSAHS on immunophenotypes was observed.However,two lymphocyte subsets were found to have a significant association with the risk of OSAHS:Basophil%CD33dim HLA DR-CD66b-(OR=1.03,95%CI=1.01-1.03,P<0.001);CD38 on IgD+CD24-B cell(OR=1.04,95%CI=1.02-1.04,P=0.019).CONCLUSION This study shows a strong link between immune cells and OSAHS through a gene approach,thus offering direction for potential future medical research.

Obstructive sleep apnea-hypopnea syndrome immunological relationship

Obstructive sleep apnea-hypopnea syndrome(OSAHS)is a complex disorder cha-racterized by symptoms resulting from intermittent hypoxia and hypopnea,with research indicating a crucial role of immune system dysregulation and genetic variations in its pathogenesis.A recent Zhao et al study utilizes Mendelian ran-domization analysis to explore the causal relationship between immune cell characteristics and OSAHS.The study identifies specific lymphocyte subsets as-sociated with OSAHS,providing valuable insights into the disease's pathophy-siology and potential targets for therapeutic intervention.The findings underscore the significance of genetic and immunological factors in sleep disorders,offering a fresh perspective on OSAHS's complexities.Compared to existing literature,Zhao et al's study stands out for its focus on genetic markers and specific immune responses associated with OSAHS,expanding upon previous research primarily centered on systemic inflammation.In conclusion,the study represents a signi-ficant advancement in the field,shedding light on the causal role of immune cells in OSAHS and paving the way for future research and targeted treatments.

Investigation on Risk Factors of Cerebrocardiac Vascular Thrombotic Diseases in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

Objective: To observe the risk factors of thrombosis in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods: From February 2001 to April 2003, 24 patients with moderate and severe OSAHS (OSAHS group) and 19 healthy adults (control group) were recruited. Their blood samples were drawn at 6∶00 and 16∶00 respectively for testing hemocrit, platelet aggregation (PAG), whole blood viscosity (WBV), prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (Fng) and endothelin (ET).Results: There was a significantly higher hemocrit, WBV, Fng and ET as well as a significant shortening of PT and APTT at 6∶00 than that at 16∶00 in OSAHS group. However, there was no significant difference in all testing items between 6∶00 and 16∶00 in control group. The hemocrit, WBV, PAG, plasma Fng and ET were significantly higher, and PT and APTT were obviously shorter at 6∶00 in OSAHS group than those at 6∶00 in control group. A higher hemocrit, PAG, plasma Fng and ET, a longer PT and APTT were observed at 16∶00 in OSAHS group, compared with those at 16∶00 in control group.Conclusion: In OSAHS patients there were striking risk factors of thrombosis, which is more remarkable in the early morning than in the afternoon.

Detection of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome using mismatch negativity

In this experiment, 97 patients with obstructive sleep apnea hypopnea syndrome were divided into three groups （mild, moderate, severe） according to minimum oxygen saturation, and 35 healthy subjects were examined as controls. Cognitive function was determined using the mismatch negativity paradigm and the Montreal Cognitive Assessment. The results revealed that as the disease worsened, the mismatch negativity latency was gradually extended, and the amplitude gradually declined in patients with obstructive sleep apnea hypopnea syndrome. Importantly, mismatch negativity latency in severe patients with a persistent time of minimum oxygen saturation 〈 60 seconds was significantly shorter than that with a persistent time of minimum oxygen saturation 〉 60 seconds. Correlation analysis revealed a negative correlation between minimum oxygen saturation latency and Montreal Cognitive Assessment scores. These findings indicate that intermittent night-time hypoxemia affects mismatch negativity waveforms and Montrea Cognitive Assessment scores. As indicators for detecting the cognitive functional status of obstructive sleep apnea hypopnea syndrome patients, the sensitivity of mismatch negativity is 82.93%, the specificity is 73.33%, the accuracy rate is 81.52%, the positive predictive value is 85.00%, the negative predictive value is 70.21%, the positive likelihood ratio is 3, and the negative likelihood ratio is 0.23. These results indicate that mismatch negativity can be used as an effective tool for diagnosis of cognitive dysfunction in obstructive sleep apnea hypopnea syndrome patients.

Clinical observation of soft palate-pharyngoplasty in the treatment of obstructive sleep apnea hypopnea syndrome in children

BACKGROUND Childhood obstructive sleep apnea hypopnea syndrome(OSAHS)is a common clinical disease that can cause serious complications if not treated in time.The preferred treatment for OSAHS in children is surgery.AIM To observe the effects of soft palate-pharyngoplasty on postoperative outcome,pharyngeal formation,and possible complications.METHODS A total of 150 children with snoring,hernia,and mouth breathing were selected.A polysomnography test was performed to confirm the diagnosis of OSAHS.The children were randomly divided into experimental and control groups.The experimental group underwent adenoidectomy,tonsillectomy,and soft palatepharyngoplasty.The control group underwent adenoidectomy and tonsillectomy.The t-test and chi-square test were used to compare conditions such as postoperative fever,postoperative hemorrhage,and pharyngeal reflux.Postoperative efficacy and complications were interrogated and observed in the form of outpatient follow-up and telephone follow-up at 6 mo and 1 year after surgery.The curative effects were divided into two groups:Cure(snoring,snoring symptoms disappeared)and non-cure.RESULTS The effective rate of the experimental group was significantly higher than that of the control group,but the difference was not statistically significant(P>0.05).The incidence of postoperative bleeding was lower in the experimental group.There was no postoperative pharyngeal reflux in either group.In the experimental group,the incidence of hyperthermia(body temperature exceeded 38.5°C)was lower than that in the control group.The difference in postoperative swallowing pain scores between the experimental and control groups was significant.CONCLUSION Soft palate-pharyngoplasty can more effectively enlarge the anteroposterior diameter and transverse diameter of the isthmus faucium.Compared with surgery alone,it can better treat OSAHS in children,improve the curative effect,reduce the risk of perioperative bleeding,close the surgical cavity,reduce the risk of postoperative infection,reduce the proportion of postoperative fever,and accelerate healing.Although this process takes more time,it is simple,safe,and effective.

Correlation of obstructive sleep apnea hypopnea syndrome with metabolic syndrome in snorers

Though obstructive sleep apnea hypopnea syndrome（OSAHS） and metabolic syndrome（MS） are correlated;the contributing factors for the occurrence of MS in Chinese snorers remain largely undefined.We aimed to investigate the associated pathogenesis of coexistence of OSAHS and MS in Chinese snorers.A total of 144 Chinese habitual snorers were divided into 3 groups,the control group（simple snorers）（n = 36）,the mild OSAHS group（n= 52）and the moderate-to-severe OSAHS group（n = 56）.The incidence of MS in the moderate-to-severe OSAHS group（26.8%） was significantly higher than that in the control group（8.3%）,the mild OSAHS group（11.1%） and all the OSAHS patients（19.45%）（all P 〈 0.05）.Homeostatic model assessment（HOMA） index and proinsulin（PI） were negatively correlated with nocturnal meanSpO2 and miniSpO2.Meanwhile,nocturnal SpO2 were negatively correlated with body mass index,waist and neck circumferences and diastolic blood pressure,but positively correlated with total cholesterol and high-density lipoprotein cholesterol.The study indicated that in Chinese snorers,moderate-to-severe OSAHS was closely associated with MS via nocturnal hypoxemia.

Relationship between obstructive sleep apnea hypopnea syndrome and cardiovascular disorders in adult snorers

Objective：To investigate the relationship between sleep apnea hypopnea syndrome（OSAHS） and some cardiovascular disorders in adult habitual snorers as well as the effectiveness of nasal continuous positive airway pressure（NCPAP） on those with OSAHS. Methods： With the use of polysomnography, 262 adult habitual snorers were examined and divided into the OSAHS group and the Non-OSAHS group （control）. Using ambulatory electrocardiogram and blood pressure measurement, daily nocturnal rhythm of blood pressure, hypertension, heart rate variability, some arrythmias and angina pectoris of coronary heart disease were monitored and compared between the two groups, before and after 14 days of treatment with NCPAP in the OSAHS group. Results.This study indicated a higher incidence （39.6%） of OSAHS in adult snorers and demonstrated that there was a significantly higher incidence of hypertension, disappearance of the daily nocturnal rhythm of blood pressure, poor effectiveness of nitrate on angina pectoris of coronary heart disease, decreased heart rate variability during sleep, increased arrythmias and lower SpO2 levels in the OSAHS group than in the Non-OSAHS group. After NCPAP treatment during sleep, snoring control, significantly higher SpO2 and lower apnea hypopnea indices were achieved in the OSAHS group; heart rate variability and daily nocturnal rhythm of blood pressure returned to normal levels. Conclusion：The results of this research suggested that there was a close relationship between the development of OSAHS and some cardiovascular disorders. Furthermore, NCPAP treatment was effective not only on OSAHS but also on coexisting cardiovascular disorders.

The Clinical effect of the Acupuncture treatment on the Patients with Obstructive sleep apnea hypopnea syndrome combined with Hypertension

Objective:To research the effect of conventional treatment(Gingko biloba extract(GBE)+continuous positive airway pressure(CPAP)ventilation)combined with acupuncture on the changes of blood pressure,respiratory efficiency,oxidative index,and clinical effect in patients with OSAHS combined with hypertension.Method Selecting 80 patients with OSAHS combined with hypertension,then they were randomly divided into observation group(n=40)and control group(n=40).The patients in the control group were given conventional drug therapy(GBE)and rehabilitation and CPAP,and the observation group were given acupuncture on this basic,they were treated 14 days.The primary endpoints were the changes from baseline to day 14 in blood pressure;the secondary endpoints were changes from baseline to day 14 in the respiratory efficiency(PSG);the tertiary endpoints were changes from baseline to day 14 in the oxidative related substances(SOD,GSH-Px,ROS,and MDA).Results After 14-day treatment,the respiratory efficiency index were better than pretherapy(p<0.05),and the observation group were better than control group(p<0.05);the blood pressure were lower than pretherapy(p<0.05),and the observation group were lower than control group(p<0.05);the ROS and MDA were lower than pretherapy(p<0.05),and the observation group were lower than control group(p<0.05);the SOD,GSH-Px were higher than pretherapy(p<0.05),and the observation group were higher than control group(p<0.05);the clinical effect of hypotensive in the observation group were better control group(p<0.05).Conclusion 14-day treatment of conventional treatment combined with acupuncture can improve the imbalance of oxidation and antioxidation and blood pressure.

Clinical analysis of obstructive sleep apnea hypopnea syndrome in children

A case of obstructive sleep apnea hypopnea syndrome(OSAHS)in the Department of Otolaryngology of the Third Affiliated Hospital of Inner Mongolia Medical School was collected.The incidence of this disease is high,which seriously threatens the physical and mental health of children,but it has not been paid enough attention by medical workers and parents.We hope we can make early discovery and treatment,relieve upper airway obstruction factors,prevent and treat complications for children with OSAHS through the case analysis,so as to improve their quality of life.

Serum Level of Vascular Endothelial Growth Factor in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

To explore the relationship between the serum vascular endothelial growth factor （VEGF） level and the severity of obstructive sleep apnea hypopnea syndrome （OSAHS）, the concentrations of serum VEGF in 40 OSAHS patients and 9 healthy controls were measured by using ELISA method. Meanwhile the correlation between the concentration of VEGF and parameters of polysomnography （PSG） was examined. Our results showed that the concentrations of VEGF were significantly higher in OSAHS patients with severe hypoxia （536.8±334.7 pg/mL） than in those with mild hypoxia （329.2±174.7 pg/mL） and healthy controls （272. 8±211.0 pg/mL） （P〈0.05 for both）. The concentrations of VEGF were also significantly higher in OSAHS patients with hypertension （484.5±261.4 pg/mL） than in those without hypertension （311.0±158.4 pg/mL） and healthy controls （272. 8±211.0 pg/mL） （P〈0.05 for both）. There was a positive correlation between the concentration of VEGF and the apnea hypopnea index （AHI） （r=0.34, P〈0.05）. It is concluded that the concentration of the serum VEGF is positively related to the severity of OSAHS. The elevated serum VEGF level may be involved in the pathogenesis of the complications of obstructive sleep apnea hypopnea syndrome.

Numerical analysis for the effcacy of nasal surgery in obstructive sleep apnea hypopnea syndrome

In the present study, we reconstructed upper airway and soft palate models of 3 obstructive sleep apnea-hypopnea syndrome（OSAHS） patients with nasal obstruction. The airflow distribution and movement of the soft palate before and after surgery were described by a numerical simulation method. The curative effect of nasal surgery was evaluated for the three patients with OSAHS. The degree of nasal obstruction in the 3 patients was improved after surgery. For 2 patients with mild OSAHS, the upper airway resistance and soft palate displacement were reduced after surgery. These changes contributed to the mitigation of respiratory airflow limitation. For the patient with severe OSAHS, the upper airway resistance and soft palate displacement increased after surgery, which aggravated the airway obstruction. The effcacy of nasal surgery for patients with OSAHS is determined by the degree of improvement in nasal obstruction and whether the effects on the pharynx are beneficial. Numerical simulation results are consistent with the polysomnogram（PSG） test results, chief complaints, and clinical findings, and can indirectly reflect the degree of nasal patency and improvement of snoring symptoms, and further,provide a theoretical basis to solve relevant clinical problems.

Association of adiponectin genotype polymorphisms at positions 45 and 276 with obstructive sleep apnea hypopnea syndrome

Objective： To investigate the relationship between adiponectin genotype polymorphisms and obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods： Using the TaqMan polymerase chain reaction（PCR） method, the single nucleotide polymorphisms（SNP） at positions 45 and 276 in the adiponectin gene were determined in Chinese of the Han nationality in the Nanjing district. The OSAHS group consisted of 78 patients, and the control group contained 40 subjects. The association of adiponectin genotype polymorphisms at positions 45 and 276 with obstructive sleep apnea hypopnea syndrome was analyzed. Results： No evidence of a direct association was found between OSAHS and adiponectin genotype SNP at positions 45 and 276（P〉 0.05）. However, compared with those OSAHS patients having G/T＋T/T genotype at position 276, the OSAHS patients with the G/G genotype showed a greater neck circumference（NC）, a prolonged duration of the longest apnea event, and elevated levels of blood cholesterol and low-density lipoprotein cholesterol（P 〈 0.05）. Conclusion： No direct association was detected between OSAHS and adiponectin genotype distribution at positions 45 and 276 in Chinese of Han nationality in the Nanjing district. However, OSAHS patients with the adiponectin G/G genotype at position 276 had a larger NC and the longest apnea event compared to those having the adiponectin SNP276 G/T ＋T/T genotype. This may have an indirect influence on the development of OSAHS,

Risk factors of atherosclerosis in elderly senile obstructive sleep apnea hypopnea syndrome patients with hypertension and type 2 diabetes

Objective: To explore the related factors of atherosclerosis in senile obstructive sleep apnea hypopnea syndrome (OSAHS) patients. Methods: 129 outpatients and inpatients with senile hypertension and type 2 diabetes were chosen from Department of Geri-atrics during May of 2012 to January of 2014. The sleep breath monitoring was performed to each patient in the early stage. According to the presence or absence of OSAHS, they were divided into OSAHS (n = 60) and non-OSAHS (n = 69) groups. And 30 healthy elderly subjects recruited in Physical Examination Department of our hospital were included in the control group. The parameters of age, gender, height, body mass index, hypersensitive C-reactive protein (Hs-CRP), homocysteine (Hcy), triglyc-eride (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) and carotid intima-media thickness (CIMT) were recorded. The comparison of Hs-CRP, Hcy, TG, TC, HDL-C, LDL-C and CIMT between OSAHS and non-OSAHS groups was made;and the comparison with the normal control group was made to analyze the correlations of CIMT to the above-mentioned indexes. Results: The levels of Hs-CRP [(3.40 ± 0.91) mg/L, (2.57 ± 1.01) mg/L], Hcy [(16.50 ± 2.89) μmol/L, (11.20 ± 2.32) μmol/L], CIMT [(1.06 ± 0.14) mm, (0.93 ± 0.13) mm], TG [(2.52 ± 1.40) mmol/L, (2.51 ± 2.02) mmol/L], TC [(5.74 ± 1.16) mmol/L, (5.49 ± 1.09) mmol/L] and LDL-C [(3.15 ± 0.47) mmol/L, (3.05 ± 0.70) mmol/L] in both OSAHS and non-OSAHS groups were higher than those in normal control group [Hs-CRP: (2.06 ± 1.22) mg/L, Hcy: (6.04 ± 1.85) μmol/L, CIMT: (0.65 ± 0.07) mm, TG: (0.99 ± 0.24) mmol/L, TC: (3.63 ± 0.71) mmol/L and LDL-C: (2.47 ± 0.27) mmol/L];the levels of Hs-CRP, Hcy, CIMT and plaque score in OSAHS group were higher than those in non-OSAHS group [plague score: (1.92 ± 1.03) vs. (1.35 ± 0.97) points], the difference was of statistical significance (OSAHS group vs. control group, t = 5.88, 18.15, 15.62, 5.91, 9.17, 7.47;non-OSAHS group vs. control group, t = 2.20, 10.73, 11.51, 4.09, 8.56, 4.45;OSAHS group vs. non-OSAHS group, t = 4.84, 11.72, 5.54, 3.91, all p < .05). Related analyses showed that CIMT and plaque score in OSAHS group were correlated to age, BMI, TG, TC, LDL-C, Hs-CRP and Hcy respectively. Conclusions: OSAHS may elevate the level of inflammatory cytokines and cause atherosclerosis. And the changes of CIMT, Hs-CRP and Hcy are in parallel. Hcy also has an identically important clinical significance in the progress of atherosclerosis.

Effect of nocturia in patients with different severity of obstructive sleep apnea on polysomnography: A retrospective observational study

Patients with suspected OSA were examined using PSG.They were divided into two groups based on the presence of nocturia.Nocturia was defined as a patient who needed to void at least once.Apneaehypopnea index(AHI)was employed to classify patients according to degrees of severity:AHI<5 events/h,5 events/hAHI<15 events/h,15 events/hAHI<30 events/h,and AHI30 events/h,defined as normal,mild OSA,moderate OSA,and severe OSA,respectively.Demographic variables,PSG parameters,International Prostate Symptom Scores(IPSSs),and quality of life scores due to urinary symptoms were analyzed.Results:In total 140 patients,114 patients had OSA(48 had mild OSA;34 had moderate OSA;and 32 had severe OSA)and 107 patients had nocturia.The total IPSS was significantly higher in nocturia patients in all groups except the group of severe OSA patients.With the increasing severity of OSA,more correlated factors related to nocturia were determined.In mild OSA patients,nocturia related to increased age(p=0.025),minimum arterial blood oxygenation saturation(p=0.046),and decreased AHI of non-rapid eye movement(p=0.047),AHI of total sleep time(p=0.010),and desaturation index(p=0.012).In moderate OSA patients,nocturia related to increased age(p<0.001),awake time(p=0.025),stage 1 sleep(p=0.033),and sleep latency(p=0.033),and decreased height(p=0.044),weight(p=0.025),and sleep efficiency(p=0.003).In severe OSA patients,nocturia related to increased weight(p=0.011),body mass index(p=0.009),awake time(p=0.008),stage 1 sleep(p=0.040),arousal number(p=0.030),arousal index(p=0.013),periodic limb movement number(p=0.013),and periodic limb movement index(p=0.004),and decreased baseline arterial blood oxygenation saturation(p=0.046).Conclusion:Our study revealed that there were more correlated factors related to nocturia with increasing severity of OSA.This study helps in clinical education and treatment for OSA patients with different severity.

Recent advances in managing obstructive sleep apnea

Obstructive sleep apnea(OSA)is a rapidly increasing global concern.If it remains untreated,it can lead to cardiovascular,metabolic,and psychiatric complications and may result in premature death.The efficient and effective management of OSA can have a beneficial effect and help reduce the financial burden on the health sector.There has been constant development in OSA management,and numerous options are available.The mainstay of therapy is still the conventional measures and behavioral modifications.However,in cases of failure of these modalities,surgical therapy is the only option.Numerous studies have shown that proper management of OSA has beneficial effects with good long-term outcomes.

Risk factors and management countermeasures for obstructive sleep apnea hypoventilation syndrome in children

BACKGROUND Obstructive sleep apnea hypoventilation syndrome(OSAHS)in children is a sleep respiratory disorder characterized by a series of pathophysiologic changes.Statistics in recent years have demonstrated an increasing yearly incidence.AIM To investigate the risk factors for OSAHS in children and propose appropriate management measures.METHODS This study had a case–control study design.Altogether,85 children with OSAHS comprised the case group,and healthy children of the same age and sex were matched at 1:1 as the control group.Basic information,including age,sex,height,weight and family history,and medical history data of all study participants were collected.Polysomnography was used to detect at least 8 h of nocturnal sleep.All participants were clinically examined for the presence of adenoids,enlarged tonsils,sinusitis,and rhinitis.RESULTS The analysis of variance revealed that the case group had a higher proportion of factors such as adenoid grading,tonsil indexing,sinusitis,and rhinitis than the control group.CONCLUSION A regression model was established,and glandular pattern grading,tonsil indexing,sinusitis,and pharyngitis were identified as independent risk factors affecting OSAHS development.

Obstructive sleep apnea:Overlooked comorbidity in patients with diabetes

In this review article,we explore the interplay between obstructive sleep apnea(OSA)and type 2 diabetes mellitus(T2DM),highlighting a significant yet often overlooked comorbidity.We delve into the pathophysiological links between OSA and diabetes,specifically how OSA exacerbates insulin resistance and disrupts glucose metabolism.The research examines the prevalence of OSA in diabetic patients and its role in worsening diabetes-related complications.Emphasizing the importance of comprehensive management,including weight control and positive airway pressure therapy,the study advocates integrated approaches to improve outcomes for patients with T2DM and OSA.This review underscores the necessity of recognizing and addressing OSA in diabetes care to ensure more effective treatment and better patient outcomes.

Burdened breaths:The influence of depression on obstructive sleep apnea

Depression and metabolic syndrome could exacerbate the risks of the other,leading to a series of severe coexisting conditions.One notable comorbidity that must be mentioned is obstructive sleep apnea(OSA).Current studies suggested that depression increases susceptibility to OSA.As the prevalence of depression rises,it becomes critical to prevent and manage its complications or comorbidities,including OSA.Predictive models,non-invasive electroencephalogram moni-toring,genetic research,and other promising technologies are being applied to the prevention,diagnosis,and personalized treatment of depression and OSA.

The Relationship Between NLRP3 Inflammasome and Its Downstream Inflammatory Factors in Obstructive Sleep Apnea Patients with Carotid Atherosclerosis Under Cigarette Exposure

Aim:To study the relationship between NLRP3(nucleotide oligomerization domain[NOD]-,leucine-rich repeats[LRR]-,and pyrin domain-containing protein 3)inflammasome and its downstream inflammatory factors in obstructive sleep apnea(OSA)patients with carotid atherosclerosis(CAS)under cigarette exposure,further exploring the risk factors of CAS in OSA patients.Methods:A total of 109 adult males who underwent polysomnography and carotid artery ultrasonography in our hospital from October 2019 to December 2021 were selected.According to the detection results,they were divided into the OSA group,the CAS group,and the OSA combined CAS group;additionally,29 healthy subjects who underwent a physical examination were also included.According to whether they were smoking,the groups were further divided into smoking and non-smoking groups.The age,body mass index(BMI),blood pressure,apnea-hypopnea index(AHI),lowest blood oxygen saturation(LSaO2),carotid intima-media thickness(CIMT),levels of blood sugar,blood low-density lipoprotein cholesterol(LDLc),and serum NLRP3,interleukin-1β(IL-1β),and interleukin-18(IL-18)of all subjects were recorded.Results:The OSA combined CAS group had higher LDLc levels and AHI and lower LSaO2 than the OSA group and CAS group.The levels of serum NLRP3,IL-1β,and IL-18 in the OSA group were higher than those in the normal control group(P<0.05);and those in the OSA combined CAS group were higher than the OSA group and CAS group(P<0.05),regardless of cigarette exposure.Considering cigarette exposure,serum NLRP3,IL-1β,and IL-18 levels were higher in the OSA,CAS,and OSA combined CAS smoking groups than those in the non-smoking group(P<0.05).Under cigarette exposure,AHI,LDLc,NLRP3,IL-1β,and IL-18 were significantly positively correlated(P<0.05),and LSaO2 was negatively correlated with CAS in OSA(P<0.05).AHI,LSaO2,LDLc,NLRP3,and IL-1βare the risk factors for OSA combined with CAS.Conclusion:LSaO2,AHI,LDLc,NLRP3,and IL-1βare the important risk factors for OSA combined with CAS under cigarette exposure,and their levels can be used to predict the occurrence of CAS in OSA.

Forced Inspiratory Flow Volume Curve in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

Objective: Obstructive sleep apnea-hypopnea syndrome (OSA) is a disease of obstructive apnea or hypopnea caused by a repeated partial or complete collapse of the upper airway during sleep. The inspiratory part of the flow-volume curve (F-V curve) can be used as an auxiliary means to evaluate upper airway obstruction in adults. This study is to evaluate the ability of the F-V curve to predict the OSA and explore inspiratory indicators related to airway obstruction during sleep. Methods: There were 332 patients included in this cross-sectional study, who were accompanied by snoring, daytime sleepiness and other symptoms, with suspicion of OSA. According to the nocturnal polysomnography, the subjects were distributed into mild to moderate OSA group, severe OSA group and non-OSA group. A pulmonary function test was used to collect the subjects’ spirometry and F-V curves. Results: There was no significant difference in a variety of indices derived from the F-V curve between OSA and normal subjects, including 25% inspiratory flow rate, middle inspiratory flow rate, 75% inspiratory flow rate, peak flow rate, and forced inspiratory flow rate in the first second. The pulmonary function parameters were significantly correlated with the weight, age and sex of the subjects. Conclusion: These findings suggest that the inspiratory curve of pulmonary function cannot evaluate the upper airway abnormalities in patients with obstructive apnea-hypopnea syndrome.