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

Abstract

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 Geriatrics 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), triglyceride (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.