Sleep apnoea and endothelial dysfunction: An individual patient data meta-analysis.
Endothelial function
Obstructive sleep apnoea
Reactive hyperaemia index
Journal
Sleep medicine reviews
ISSN: 1532-2955
Titre abrégé: Sleep Med Rev
Pays: England
ID NLM: 9804678
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
12
09
2019
revised:
17
12
2019
accepted:
05
02
2020
pubmed:
3
4
2020
medline:
15
7
2021
entrez:
3
4
2020
Statut:
ppublish
Résumé
We performed an individual patient data meta-analysis to investigate the association between obstructive sleep apnoea (OSA) severity and the reactive hyperaemia index (RHI) measured by peripheral arterial tonometry (PAT), a validated measurement of endothelial function, and a strong predictor of late cardiovascular (CV) events. Patients from 12 studies underwent PAT and overnight polysomnography or respiratory polygraphy for suspected OSA. Endothelial dysfunction was defined by a log-transformed RHI<0.51. Subgroup analyses were performed to investigate this relationship in specific populations. Among 730 patients without overt CV disease, 387 (53.0%) had severe OSA (apnoea-hypopnea index ≥30) and 164 (22.5%) exhibited endothelial dysfunction. After adjustment for age, gender, diastolic blood pressure, obesity, diabetes and chronic obstructive pulmonary disease, endothelial dysfunction was associated with severe OSA (odds ratio, OR [95% confidence interval]: 2.27 [1.12-4.60]; p = 0.02), and nocturnal hypoxemia defined by >20 min with oxygen saturation <90% (OR: 1.83 [1.22-2.92]; p = 0.004) or mean oxygen saturation <92% (OR: 1.52 [1.17-1.96]; p = 0.002). On subgroup analyses, the association between severe OSA and endothelial dysfunction was not significant in patients with hypertension, obesity and/or diabetes. Among adults without overt CV disease, severe OSA is independently associated with an increased risk of endothelial dysfunction that may predispose to late CV events.
Identifiants
pubmed: 32234658
pii: S1087-0792(20)30052-6
doi: 10.1016/j.smrv.2020.101309
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
101309Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest FGag reports personal fees from AIR LIQUIDE SANTE, CIDELEC, RESMED, SEFAM, outside the submitted work; non-financial support from AIR LIQUIDE SANTE, ASTEN SANTE, SEFAM, outside the submitted work. JLP reports grants from AGIRADOM, AIR LIQUIDE FOUNDATION, PHILIPS RESPIRONICS, RESMED, SEFAM, VITALAIR, outside the submitted work; personal fees from AGIRADOM, ITAMAR, JAZZ PHARMACEUTICALS, PHILIPS RESPIRONICS, RESMED, SEFAM, outside the submitted. VB, RT, WT, RA, Mathieu Berger, FGou, MJF, IJD, SL, MLV, MCM, and FR report no conflict of interest.