重度阻塞性睡眠呼吸暂停与接受心脏手术患者胆固醇目标未达标相关：一项前瞻性观察队列的二次分析
Severe Obstructive Sleep Apnea Is Associated with Cholesterol Target Non-Attainment in Patients Undergoing Cardiac Surgery: A Secondary Analysis of a Prospective Observational Cohort.
文献信息
| PMID | 42942276 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Andrei Raul Manzur |
| 作者单位 | Doctoral School of Medicine and Pharmacy, Victor Babeș University of Medicine and Pharmacy Timișoara, Piața Eftimie Murgu No. 2, 300041 Timișoara, Romania. |
| 期刊 | Life (Basel, Switzerland) |
| SCI 分区 | Q1 |
| IF | 3.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 阻塞性睡眠呼吸暂停（OSA）与不良心脏代谢特征相关，但其与接受降脂治疗患者胆固醇目标达标情况的关系仍未完全明确。我们研究了接受择期心脏手术患者中重度OSA与未达到预设胆固醇阈值之间的关联。
方法： 本二次分析纳入来自前瞻性组建观察队列的142名成人。参与者接受院内术前III型心肺便携式监测、空腹血脂评估以及降脂治疗记录。重度OSA定义为呼吸暂停低通气指数≥30次/小时。主要结局为非高密度脂蛋白胆固醇（non-HDL-C）≥100 mg/dL。多变量模型校正了年龄、性别、体重指数、糖尿病、高强度他汀治疗以及非他汀类降脂治疗。
结果： 重度OSA与non-HDL-C≥100 mg/dL的更高比值比相关（校正比值比[OR] 3.49，95%置信区间[CI] 1.56-7.78；p=0.002）、LDL-C≥55 mg/dL（OR 2.93，95% CI 1.18-7.29；p=0.021）以及LDL-C≥70 mg/dL（OR 2.30，95% CI 1.03-5.12；p=0.041）。相比之下，与连续性LDL-C（p=0.113）和non-HDL-C（p=0.100）浓度的关联无统计学显著性。未观察到甘油三酯相关或脂质衍生结局的显著关联。在仅限他汀治疗患者的分析中，与non-HDL-C≥100 mg/dL的主要关联仍然显著。
结论： 在该心脏手术队列中，重度OSA与未达到预设胆固醇阈值相关，其中non-HDL-C≥100 mg/dL的关联最强且最一致。这些发现识别了与分类胆固醇目标未达标的关联，但并未确立治疗失败、因果关系或胆固醇浓度的普遍升高。
英文摘要
BACKGROUND: Obstructive sleep apnea (OSA) has been associated with adverse cardiometabolic profiles, but its relationship with cholesterol target attainment in patients receiving lipid-lowering therapy remains incompletely characterized. We investigated the association between severe OSA and non-attainment of predefined cholesterol thresholds in patients undergoing elective cardiac surgery.
METHODS: This secondary analysis included 142 adults from a prospectively assembled observational cohort. Participants underwent in-hospital preoperative Type III cardiorespiratory polygraphy, fasting lipid assessment, and documentation of lipid-lowering therapy. Severe OSA was defined as an apnea-hypopnea index ≥30 events/h. The primary outcome was non-high-density lipoprotein cholesterol (non-HDL-C) ≥ 100 mg/dL. Multivariable models were adjusted for age, sex, body mass index, diabetes mellitus, high-intensity statin therapy, and non-statin lipid-lowering therapy.
RESULTS: Severe OSA was associated with higher odds of non-HDL-C ≥ 100 mg/dL (adjusted odds ratio [OR] 3.49, 95% confidence interval [CI] 1.56-7.78; p = 0.002), LDL-C ≥ 55 mg/dL (OR 2.93, 95% CI 1.18-7.29; p = 0.021), and LDL-C ≥ 70 mg/dL (OR 2.30, 95% CI 1.03-5.12; p = 0.041). In contrast, associations with continuous LDL-C (p = 0.113) and non-HDL-C (p = 0.100) concentrations were not statistically significant. No significant associations were observed for triglyceride-related or lipid-derived outcomes. The primary association with non-HDL-C ≥ 100 mg/dL remained significant in the analysis restricted to statin-treated patients.
CONCLUSIONS: Severe OSA was associated with non-attainment of predefined cholesterol thresholds in this cardiac surgical cohort, with the strongest and most consistent association observed for non-HDL-C ≥ 100 mg/dL. These findings identify an association with categorical cholesterol target non-attainment but do not establish treatment failure, causality, or a generalized increase in cholesterol concentrations.