Effects of obstructive sleep apnea syndrome on clinical and instrumental indicators in obese patients

Abstract

Due to the high prevalence of obstructive sleep apnea syndrome (OSAS), its diagnosis and treatment remains one of the urgent problems of medicine. Hypodiagnosis of OSAS is observed in everyday clinical practice. The early OSAS diagnosis and treatment, including the use of non‑invasive assisted ventilation of the lungs with constant positive pressure during sleep, could prevent the development and progression of cardiovascular diseases, and significantly improve the quality of life of a person.
 Objective — to assess OSAS impact on the clinical and instrumental indicators in obese patients, to establish correlation between the characteristics of cardiorespiratory sleep monitoring and indicators of carbohydrate and lipid metabolism in obese patients.
 Materials and methods. Observations involved 78 patients with I ‑ II degree obesity. According to the results of cardiorespiratory monitoring (CRM) of sleep, three groups of obese patients were formed. The first group included 26 patients with an apnea‑hypopnea index <30 episodes per hour (mild OSAS degree). The second group was consisted of 26 patients with apnea/hypopnea index (AHI) over 30 episodes per hour (severe OSAS degree). The groups matched by percentage of men and women, the mean age and body mass index.
 Results. An increase in body weight and body mass index (BMI) in obese patients was associated with an increase in the number and total duration of episodes of apnea/hypopnea, AHI, as well as a decrease in blood oxygen saturation (SpO2). Parameters of waist circumference (WC), hip circumference (HC), WC/HC positively correlated with the number and duration of episodes of apnea/hypopnea, AHI, and negatively correlated with SpO2. Positive values of the Spearman r coefficient ranged from 0.23 to 0.57, negative values — from –0.26 to –0.48 (р <0.05).
 Conclusions. In obese patients with OSAS, the parameters of cardiorespiratory sleep monitoring — apnea‑hypopnea index, total duration of apnea episodes, directly correlated with body mass index, waist circumference, blood pressure level, total cholesterol, blood triglycerides. An inverse correlation was found between oxygen saturation and fasting glycemia and the level of glycated hemoglobin.