背景:影响个体日常生活的最普遍的睡眠障碍之一是阻塞性睡眠呼吸暂停(OSA),肥胖是一个主要的危险因素。一些新的脂质指数被认为与OSA有关联,其中内脏肥胖指数(VAI),血浆致动脉粥样硬化指数(AIP),和脂质积累产物(LAP)是最重要的。在这里,本研究旨在系统研究这些指标与OSA之间的关联.
方法:四个国际数据库,包括PubMed,Scopus,WebofScience,和Embase进行了搜索,以找到研究LAP的相关研究,VAI,或OSA中的AIP,并与非OSA病例或不同程度的OSA病例进行比较。随机效应荟萃分析用于生成OSA和非OSA病例之间血脂指数差异的标准化平均差(SMD)和95%置信区间(CI)。此外,通过随机效应荟萃分析计算了在基于这些脂质指数诊断OSA的单项研究中观察到的受试者工作特征曲线(AUC)下的合并面积.
结果:共纳入14项原始研究,共14943例。AIP,LAP,VAI在8个月中进行了评估,五,和五项研究,分别。总的来说,这些血脂指标具有可接受的诊断能力(AUC0.70,95%CI0.67~073).Meta分析显示OSA患者AIP明显增高(SMD0.71,95%CI0.45~0.97,P<0.01)。此外,在较高的OSA严重程度下,AIP也增加。关于LAP,OSA/OSA高危患者的LAP高于对照组/OSA低危患者(SMD0.53,95%CI0.25~0.81,P<0.01).根据两项研究的结果,OSA的VAI也增加了。
结论:这些发现提示OSA患者的综合血脂指数升高。此外,这些指标对OSA具有潜在的诊断和预后能力.未来的研究可以证实这些发现,并启发脂质指标在OSA中的作用。
BACKGROUND: One of the most prevalent sleep disorders affecting the individual\'s daily life is obstructive sleep apnea (OSA), for which obesity is a major risk factor. Several novel lipid indices have been suggested to have associations with OSA, among which visceral adiposity index (VAI), atherogenic index of plasma (AIP), and lipid accumulation product (LAP) are the most important ones. Herein, the current study aimed to systematically investigate the association between these indices and OSA.
METHODS: Four international databases, including PubMed, Scopus, the Web of Science, and Embase were searched in order to find relevant studies that investigated LAP, VAI, or AIP in OSA and compared them with non-OSA cases or within different severities of OSA. Random-effect meta-analysis was used to generate the standardized mean difference (SMD) and 95% confidence interval (CI) of the difference in lipid indices between OSA and non-OSA cases. Moreover, the pooled area under the receiver operating characteristic curves (AUCs) observed in individual studies for diagnosis of OSA based on these lipid indices were calculated by random-effect meta-analysis.
RESULTS: Totally 14 original studies were included, comprised of 14,943 cases. AIP, LAP, and VAI were assessed in eight, five, and five studies, respectively. Overall, these lipid indices had acceptable diagnostic ability (AUC 0.70, 95% CI 0.67 to 073). Meta-analysis revealed that AIP was significantly higher in patients with OSA (SMD 0.71, 95% CI 0.45 to 0.97, P < 0.01). Moreover, AIP also increased in higher severities of OSA. Regarding LAP, a higher LAP was observed in OSA/patients with high risk for OSA rather than in controls/low risk for OSA (SMD 0.53, 95% CI 0.25 to 0.81, P < 0.01). VAI was also increased in OSA based on results from two studies.
CONCLUSIONS: These findings suggest that composite lipid indices are increased in OSA. Also, these indices can have the potential beneficiary diagnostic and prognostic ability in OSA. Future studies can confirm these findings and enlighten the role of lipid indices in OSA.