Analysis of risk factors of prethrombotic state of obstructive sleep apnea and hyponea syndrome_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

HUANG Bin ^1△ , YANG Zengrong ¹ , BAI Hua ² , HUANG Yi ¹ ,  HE Yuanbing ¹

1. The 1^st Department of Respirtory Medicine, The 1^st Affiliated Hospital of Xinjiang Medical University. Wulumuqi, Xinjiang, 830054, P. R. China;
2. Laboratory of Polysomnography, The 1st Affiliated Hospital of Xinjiang Medical University, Wulumuqi, Xinjiang, 830054, P. R. China;

Corresponding author：

HE Yuanbing, Email: heyanyifan@163.com

Keywords：

Obstructive sleep apnea and hyponea syndrome; Prethrombotic state; Sleep apnea and hypopnea index; Interleukin-6; Chronic obstructive pulmonary disease

DOI：

10.7507/1671-6205.201609043

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Objective To analyze the risk factors of prethrombotic state of obstructive sleep apnea and hyponea syndrome (OSAHS), providing basis and reference for the prevention of prethrombotic state of OSAHS. Methods Two hundred and thirty-eight patients excluding the presence of possible effects of coagulation factors from June 2014 to July 2016 were diagnosed as OSAHS by polysomnography (PSG) and underwent coagulation, thrombosis, fibrinolysis, and inflammatory factors testing. Fifty-six patients met the standard of prethrombotic state (prethrombotic state group) and 59 patients randomly selected from the remaining 182 patients did not meet the standard (non-prethrombotic state group). The age, sex, body mass index (BMI), sleep apnea and hypopnea index (AHI), interleukin-6 (IL-6), complicating chronic obstructive pulmonary disease (COPD) and hypertension were compared between two groups. Results Non conditional Logistic regression analysis showed that the risk factors of prethrombotic state of OSAHS were age (OR=1.202, 95%CI: 1.107 to 1.305), IL-6 (OR=1.127, 95%CI: 1.014 to 1.252), AHI (OR=1.151, 95%CI: 1.055 to 1.256), and complicating COPD (OR=4.749, 95%CI: 1.046 to 21.555). Conclusion Age, AHI, IL-6, and complicating COPD may be the risk factors of prethrombotic state of OSAHS, among which complicating COPD may be the most important risk factor.

Citation： HUANG Bin, YANG Zengrong, BAI Hua, HUANG Yi, HE Yuanbing. Analysis of risk factors of prethrombotic state of obstructive sleep apnea and hyponea syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(5): 469-473. doi: 10.7507/1671-6205.201609043 Copy

1.	Peng Y H, Liao W C, Chung W S, et al. Association between obstructive sleep apnea and deep vein thrombosis/pulmonary embolism: A population-based retrospective cohort study. Thromb Res, 2014, 134(2): 340-345.
2.	Alonso-Fernandez A, de la Pena M, Romero D, et al. Association between obstructive sleep apnea and pulmonary embolism. Mayo Clin Proc, 2013, 88(6): 579-587.
3.	Lippi G, Mattiuzzi C, Franchini M. Sleep apnea and venous thromboembolism. A systematic review. Thromb Haemost, 2015, 114(5): 958-963.
4.	王鸿利. 实验诊断学. 第 2 版. 北京, 人民卫生出版社, 2010, 125-130.
5.	中华医学会呼吸病学分会睡眠呼吸障碍学组. 阻塞性睡眠呼吸暂停低通气综合征诊治指南 (2011 年修订版). 中华结核和呼吸杂志, 2012, 35(1): 9-12.0.
6.	中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南 (2013 年修订版). 中华结核和呼吸杂志, 2013, 36(4): 255-264.0.
7.	McNicholas W T. Obstructive sleep apnea and inflammation. Prog Cardiovasc Dis, 2009, 51(5): 392-399.
8.	Svensson M, Venge P, Janson C, et al. Relationship between sleep-disordered breathing and markers of systemic inflammation in women from the general population. J Sleep Res, 2012, 21(2): 147-154.
9.	Maeder M T, Strobel W, Christ M, et al. Comprehensive biomarker profiling in patients with obstructive sleep apnea. Clin Biochem, 2015, 48(4-5): 340-346.
10.	Shen P, Han Y, Cai B, et al. Decreased levels of serum nesfatin-1 in patients with obstructive sleep apnea syndrome. Sleep Breath, 2015, 19(2): 515-522.
11.	Iturriaga R, Moya E A, Del Rio R. Inflammation and oxidative stress during intermittent hypoxia: The impact on chemoreception. Exp Physiol, 2015, 100(2): 149-155.
12.	Passali D, Corallo G, Yaremchuk S, et al. Oxidative stress in patients with obstructive sleep apnoea syndrome. Acta Otorhinolaryngol Ital, 2015, 35(6): 420-425.
13.	Ntalapascha M, Makris D, Kyparos A, et al. Oxidative stress in patients with obstructive sleep apnea syndrome. Sleep Breath, 2013, 17(2): 549-555.
14.	王辰, 陈荣昌. 呼吸病学. 第 2 版. 北京: 人民卫生出版社, 2014, 243-253.
15.	Berghaus T M, Witkowska A, Wagner T, et al. Obstructive sleep apnea might trigger acute pulmonary embolism: Results from a cohort study. Clin Res Cardiol, 2016, 105(11): 938-943.
16.	Alonso-Fernandez A, Garcia Suquia A, de la Pena M, et al. Obstructive sleep apnea is a risk factor for recurrent venous thromboembolism. Chest, 2016, 150(6): 1291-1301.
17.	Alkhiary W, Morsy N E, Yousef A M, et al. Adenosine diphosphate-induced platelets aggregability in polysomnographically verified obstructive sleep apnea. Clin Appl Thromb Hemost, 2015, 22(15): 118-225.
18.	Saghazadeh A, Rezaei N. Inflammation as a cause of venous thromboembolism. Crit Rev Oncol Hematol, 2016, 99(5): 272-285.
19.	Borvik T, Braekkan S K, Enga K, et al. COPD and risk of venous thromboembolism and mortality in a general population. Eur Respir J, 2016, 47(2): 473-481.
20.	Chen W J, Lin C C, Lin C Y, et al. Pulmonary embolism in chronic obstructive pulmonary disease: A population-based cohort study. Copd, 2014, 11(4): 438-443.
21.	陈临溪, 秦旭平, 黄秋林. 血管内皮细胞药理与临床. 北京: 人民军医出版社, 2012, 7-12.
22.	Keenan C R, White R H. The effects of race/ethnicity and sex on the risk of venous thromboembolism. Curr Opin Pulm Med, 2007, 13(5): 377-383.
23.	Karamanli H, Ozol D, Ugur K S, et al. Influence of CPAP treatment on airway and systemic inflammation in OSAS patients. Sleep Breath, 2014, 18(2): 251-256.
24.	Wang Y, Su M, Zhang X. Effects of continuous positive airway pressure treatment of inflammatory factors in patients with overlap syndrome. Zhonghua Yi Xue Za Zhi, 2014, 94(6): 416-419.

1. Peng Y H, Liao W C, Chung W S, et al. Association between obstructive sleep apnea and deep vein thrombosis/pulmonary embolism: A population-based retrospective cohort study. Thromb Res, 2014, 134(2): 340-345.
2. Alonso-Fernandez A, de la Pena M, Romero D, et al. Association between obstructive sleep apnea and pulmonary embolism. Mayo Clin Proc, 2013, 88(6): 579-587.
3. Lippi G, Mattiuzzi C, Franchini M. Sleep apnea and venous thromboembolism. A systematic review. Thromb Haemost, 2015, 114(5): 958-963.
4. 王鸿利. 实验诊断学. 第 2 版. 北京, 人民卫生出版社, 2010, 125-130.
5. 中华医学会呼吸病学分会睡眠呼吸障碍学组. 阻塞性睡眠呼吸暂停低通气综合征诊治指南 (2011 年修订版). 中华结核和呼吸杂志, 2012, 35(1): 9-12.0.
6. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南 (2013 年修订版). 中华结核和呼吸杂志, 2013, 36(4): 255-264.0.
7. McNicholas W T. Obstructive sleep apnea and inflammation. Prog Cardiovasc Dis, 2009, 51(5): 392-399.
8. Svensson M, Venge P, Janson C, et al. Relationship between sleep-disordered breathing and markers of systemic inflammation in women from the general population. J Sleep Res, 2012, 21(2): 147-154.
9. Maeder M T, Strobel W, Christ M, et al. Comprehensive biomarker profiling in patients with obstructive sleep apnea. Clin Biochem, 2015, 48(4-5): 340-346.
10. Shen P, Han Y, Cai B, et al. Decreased levels of serum nesfatin-1 in patients with obstructive sleep apnea syndrome. Sleep Breath, 2015, 19(2): 515-522.
11. Iturriaga R, Moya E A, Del Rio R. Inflammation and oxidative stress during intermittent hypoxia: The impact on chemoreception. Exp Physiol, 2015, 100(2): 149-155.
12. Passali D, Corallo G, Yaremchuk S, et al. Oxidative stress in patients with obstructive sleep apnoea syndrome. Acta Otorhinolaryngol Ital, 2015, 35(6): 420-425.
13. Ntalapascha M, Makris D, Kyparos A, et al. Oxidative stress in patients with obstructive sleep apnea syndrome. Sleep Breath, 2013, 17(2): 549-555.
14. 王辰, 陈荣昌. 呼吸病学. 第 2 版. 北京: 人民卫生出版社, 2014, 243-253.
15. Berghaus T M, Witkowska A, Wagner T, et al. Obstructive sleep apnea might trigger acute pulmonary embolism: Results from a cohort study. Clin Res Cardiol, 2016, 105(11): 938-943.
16. Alonso-Fernandez A, Garcia Suquia A, de la Pena M, et al. Obstructive sleep apnea is a risk factor for recurrent venous thromboembolism. Chest, 2016, 150(6): 1291-1301.
17. Alkhiary W, Morsy N E, Yousef A M, et al. Adenosine diphosphate-induced platelets aggregability in polysomnographically verified obstructive sleep apnea. Clin Appl Thromb Hemost, 2015, 22(15): 118-225.
18. Saghazadeh A, Rezaei N. Inflammation as a cause of venous thromboembolism. Crit Rev Oncol Hematol, 2016, 99(5): 272-285.
19. Borvik T, Braekkan S K, Enga K, et al. COPD and risk of venous thromboembolism and mortality in a general population. Eur Respir J, 2016, 47(2): 473-481.
20. Chen W J, Lin C C, Lin C Y, et al. Pulmonary embolism in chronic obstructive pulmonary disease: A population-based cohort study. Copd, 2014, 11(4): 438-443.
21. 陈临溪, 秦旭平, 黄秋林. 血管内皮细胞药理与临床. 北京: 人民军医出版社, 2012, 7-12.
22. Keenan C R, White R H. The effects of race/ethnicity and sex on the risk of venous thromboembolism. Curr Opin Pulm Med, 2007, 13(5): 377-383.
23. Karamanli H, Ozol D, Ugur K S, et al. Influence of CPAP treatment on airway and systemic inflammation in OSAS patients. Sleep Breath, 2014, 18(2): 251-256.
24. Wang Y, Su M, Zhang X. Effects of continuous positive airway pressure treatment of inflammatory factors in patients with overlap syndrome. Zhonghua Yi Xue Za Zhi, 2014, 94(6): 416-419.

Chinese Journal of Respiratory and Critical Care Medicine

Analysis of risk factors of prethrombotic state of obstructive sleep apnea and hyponea syndrome

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