남성 수면무호흡증 환자에서 심혈관질환 위험도 = Cardiovascular disease risk in male obstructive sleep apnea patients

다국어 초록 (Multilingual Abstract)

BackgroundObstuctive sleep apnea(OSA) is a relatively common disorder that the prevalence is 1%-4% in adult men. It was previously assumed that this occurred because of the related obesity, however, recent data suggests that OSA may also be associated with a number of cardiovascular risk factors independently of obesity, such as hypertension, insulin resistance, impaired glucose tolerance and dyslipidemia. We studied to find the general characteristics and relation between OSA and cardiovascular disease by using Framingham risk score in Korean.MethodsWe enrolled 96 subjects in the three groups that group 1 was 28 who were snoring with AHI 〈 5. Group 2 was 35 subjects who were snoring with 5 ≤ AHI 〈 20, and group 3 was 33 who were snoring with AHI ≥ 20. We checked a basic questionnaire, physical examination, blood test, polysomnography, and searched cardiovascular 10-year risk of three groups by Framingham risk score.ResultsFasting blood glucose was a statistically significant difference between groups after adjustment for BMI, but lipid profiles and blood pressure were statistically not significant difference between groups. The summing score of systolic blood pressure(P=0.021) and total score(P=0.013) were a statistically significant difference in cardiovascular 10-year risk between groups. This study showed that 10-year cardiovascular risks by Framingham risk score estimated 2% in simple snoring subjects(group 1) and 6% in OSA subjects(group 2, 3).ConclusionsIn this study, OSA patients have high risk for cardiovascular disease in comparing cardiovascular 10 year risk by Framingham risk score. Therefore, primary care physician should concern about underdiagnosed OSA and know various practical approach to improve the symptoms.

국문 초록 (Abstract)

연구배경수면무호흡증은 성인남자 인구의 1-4%에서 나타나는 비교적 흔한 질환으로 비만과 관계되어 나타나는 현상만으로 이해되었으나 최근 비만이외에 고혈압, 인슐린 저항성, 내당 불내성, 이상 지질혈증과 같은 심혈관계 위험인자들과 수면무호흡증이 관계가 있다는 자료들이 제시되고 있다. 따라서 본 연구는 한국인에게서 수면무호흡증 환자의 고혈압, 공복시 혈당, 혈청 지질 수치 등의 일반적인 특성 및 Framingham 위험 점수를 이용하여 수면무호흡증과 심혈관 질환 위험도를 알아보고자 하였다.방 법대상군은 모두 96명으로 수면 무호흡증이 의심되어 본원에서 수면다원검사를 받은 남성환자 중 수면무호흡지수(AHI)가 5미만인 군 28명, 5에서 20미만인 군 35명, 20이상인 군 33명을 이었다. 수면다원검사 결과, 음주 및 흡연력, 신체검사, 혈중지질, 공복혈당 및 혈압을 바탕으로 Framingham 위험점수를 계산하여 각 군의 심혈관 질환 10년 위험도를 알아보았다.결 과신체질량지수를 보정한 후 군들 간에 혈압, 혈중지질, 공복혈당을 비교한 결과 공복혈당에서 유의한 차이가 있었다(P=0.028). 각 군간 각각의 Framingham 위험점수를 체질량지수로 보정한 후 비교한 결과 AHI가 높은 군일수록 수축기혈압 점수(P=0.021)와 총 점수(P=0.013)에서 유의하게 높았다. 총점수에 따른 심혈관질환의 10년 위험도는 AHI 5미만인 단순 코골이 환자군에서 2%, AHI 5이상인 수면무호흡증 환자군에서 6%였다.결 론수면무호흡증환자에서 단순코골이 환자보다 Framingham 위험점수가 높았고 심혈관 질환 10년 위험도도 높았다. 따라서 일차진료의는 과소 진단되는 수면무호흡증환자에 대한 관심을 높이고 증상을 호전시키기 위한 여러 가지 치료적 접근법을 익히는 것이 필요하다.

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