作者: Susie Yim-Yeh , Shilpa Rahangdale , Anh Tu Duy Nguyen , Amy S. Jordan , Victor Novack
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摘要: WITH THE OBESITY EPIDEMIC, PREVALENCE OF OBSTRUCTIVE SLEEP APNEA (OSA) IS ALMOST CERTAINLY ON RISE.1 MANY HAVE THEORIZED THAT repetitive hypoxemia and sympathetic surges, which characterize OSA, can lead to oxidative stress, systemic inflammation, endothelial dysfunction, and, ultimately, cardiovascular disease.2–4 OSA causes hypertension5,6 has been associated with other sequelae, such as stroke,7 ischemic heart disease, failure,8 arrhythmias.9 Physiologic studies of disease have predominantly male populations comorbid conditions who present sleep clinics. Often, data from patients clinics are matched those obese control subjects the general population or primary care Studies that include referred suspected however, may a referral bias. We sought, therefore, study effect on an but healthy recruited primarily community assess effects. Because we wanted subclinical effects in without comorbidities, limited our correlates endpoints, flow-mediated dilation (FMD), arterial stiffness, skin microvascular reactivity. FMD is measure function derived by comparing vessel before after hyperemic ischemia.10–14 Dysfunctional endothelium results decreased ischemia due reduced nitric oxide production, likely harbinger atherosclerosis.15 Arterial stiffness composite elasticity, function, tone.16,17 Although important distinctions exist between various metrics (e.g., augmentation index [AIx] pulse wave velocity),22,23 number shown increases improvements treatment continuous positive airway pressure.12,18,19,44 Finally, reactivity poor wound healing increased insulin resistance diabetes, unknown.24–26 We hypothesized would this both macrovascular (as estimated AIx). Furthermore, because age strong predictor predefined subgroup younger (< 50 years) for further analyses. theorized vascular be modulated influences differentially expressed among measurements.27 As result, speculated most pronounced participants.