Assessment of carotid artery intima‐media thickness in patients with obstructive sleep apnoea

• Published in: Clinical otolaryngology 2017-10, Vol.42 (5), p.974-978
• Main Authors: Liao, L.‐J., Cho, T.‐Y., Huang, T.‐W.
• Format: Article
• Language: English
• Subjects: Adult; Apnea; Arteriosclerosis; Atherosclerosis; Body mass; Body mass index; Breathing; Cardiovascular diseases; Cardiovascular Diseases - etiology; Carotid arteries; Carotid artery; Carotid Intima-Media Thickness; Case-Control Studies; Female; Health risk assessment; Health risks; Humans; Hypertension; Male; Middle Aged; Patients; Polysomnography; Prospective Studies; Risk assessment; Risk Factors; Risk management; Severity of Illness Index; Sleep; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnostic imaging; Sleep disorders; Ultrasound; Vascular diseases
• ISSN: 1749-4478; 1749-4486
• DOI: 10.1111/coa.12823

Objective This study compares the carotid intima‐media thickness (CIMT) in different severity of obstructive sleep apnoea (OSA) patients and assesses the role of OSA in carotid artery vasculopathy with control of multiple co‐morbidities. Study design Prospective case–control study. Setting Tertiary referral centre. Participants This study recruited 36 volunteers without the complaints of sleep‐disordered breathing, 27 patients with mild–moderate OSA and 39 patients with severe OSA. Main outcome measures The CIMT was measured using a Toshiba Aplio 500 ultrasound system (Otawara, Japan) with a 5–14 MHz L probe. Results Bilateral and mean CIMT in healthy control, mild–moderate OSA and severe OSA were 0.69 ± 0.14, 0.72 ± 0.24 and 0.94 ± 0.33, respectively (P < 0.01 in anova test). Post hoc tests show that the severe OSA group had significantly higher mean CIMT than the control and mild–moderate OSA groups (P < 0.01). With the cut‐off as 1 mm, the increased risks of cardiovascular disease (CVD) for mild–moderate and severe OSA were 11% and 39%, respectively, while no patient in the healthy control group was at risk of CVD. Multivariate linear regression could not prove that OSA itself was an independent factors for increased CIMT (mild–moderate OSA β: 0, [−0.12, 0.13]; severe OSA β: 0.08, [−0.06, 0.22], both P > 0.05) after adjusting age, hypertension and body mass index. Conclusion Automated measurement of the CIMT can be a useful tool for CVD risk assessment in patients with OSA. Severity of OSA may be an intermediate factor between multiple co‐morbidities and carotid atherosclerotic change.