老年人群中睡眠碎片化与MR左心室结构的关系:动脉粥样硬化多种族研究  

Relationship between sleep fragmentation and left ventricular structure of MR in the elderly population:the Multi-Ethnic Study of Atherosclerosis

作　　者：张鹏鹏 朱元强 刘佳丽 郑敏文 ZHANG Pengpeng;ZHU Yuanqiang;LIU Jiali;ZHENG Minwen(Xi'an Medical University,Xi'an 710068,China;Department of Radiology,Xijing Hospital,the Air Force Military Medical University,Xi'an 710032,China)

机构地区：[1]西安医学院,陕西西安710068 [2]空军军医大学西京医院放射科,陕西西安710032

出　　处：《实用放射学杂志》2024年第9期1439-1443,共5页Journal of Practical Radiology

摘　　要：目的 利用动脉粥样硬化多种族研究(MESA)队列收集的数据,以社区老年人群为研究对象,研究睡眠碎片化(SF)参数与左心室结构之间的关系.方法 纳入MESA中拥有多导睡眠图(PSG)数据和进行心脏磁共振(CMR)检查的1 404例受试者,利用PSG评估SF参数,包括入睡后清醒(WASO)、总觉醒指数(ArI-total)、快速眼动期觉醒指数(ArI-REM)和非快速眼动期觉醒指数(Arl-NREM)等.采用CMR测量左心室舒张末期质量(LVEDM).使用线性回归分析SF参数与左心室质量身高比值(LVHi)的关系.结果 单变量线性回归分析,WASO[β 0.134;95%置信区间(CI)0.023~0.052;P<0.001]、ArI-total(β 0.184;95%CI 0.203~0.362;P<0.001)、ArI-REM(β 0.116;95%CI 0.100~0.260;P<0.001)、ArI-NREM(β 0.175;95%CI 0.176~0.323;P<0.001)与LVHi呈正相关.校正混杂因素后采用多变量线性回归分析,确定WASO(β0.045;95%CI 0.001~0.024;P=0.033)与LVHi呈正相关.在女性分组中,WASO(β 0.089;95%CI 0.006~0.034;P=0.006)与LVHi增加显著相关,而在男性分组中则无此相关性.结论 一个种族多样化的队列研究中,校正可能的混杂因素后,WASO水平与LVHi增加显著相关,这种相关性表现在女性老年人群中.Objective To investigate the relationship between sleep fragmentation(SF)parameters and left ventricular structure in a community-based elderly population using data collected from the Multi-Ethnic Study of Atherosclerosis(MESA)cohort.Methods A total of 1404 participants from the MESA cohort who underwent polysomnography(PSG)and cardiac magnetic resonance(CMR)were included.PSG was used to assess SF parameters,including wake after sleep onset(WASO),arousal index-total(Arl-total),arousal index-rapid eye movement(Arl-REM),and arousal index-non-rapid eye movement(Arl-NREM).Left ventricular end-diastolic mass(LVEDM)was measured via CMR.Linear regression was employed to analyze the relationship between SF parameters and left ventricular mass to height ratio(LVHi).Results Univariate linear regression analysis showed that WASO[β0.134;95%confi-dence interval(CI)0.023-0.052;P<0.001],Arl-total(β0.184;95%CI 0.203-0.362;P<0.001),Arl-REM(β0.116;95%CI 0.1000.260;P<0.001)and Arl-NREM(β0.175;95%CI 0.176-0.323;P<0.001)were positively correlated with LVHi.After adjust-ment for confounding factors in multivariate linear regression analysis,WASO(β0.045;95%CI 0.001-0.024;P=0.033)was positively correlated with LVHi.WASO(β0.089;95%CI 0.006-0.034;P=0.006)was significantly associated with increased LVHi in the female group but not in the male group.Conclusion In an ethnically diverse cohort,WASO is significantly associated with increased LVHi after adjustment for potential confounders,especially in the female elderly population.

关 键 词：睡眠碎片化 磁共振成像 左心室 

分 类 号：R338.63[医药卫生—人体生理学] R445.2[医药卫生—基础医学] R322.11