論文No1821
Physical activity as a moderator for obstructive sleep apnoea and cardiometabolic risk in the EPISONO study
Marcos Mônico-Neto, Hanna Karen Moreira Antunes, Ronaldo Vagner Thomatieli dos Santos, Vânia D'Almeida, Altay Alves Lino de Souza, Lia Rita Azeredo Bittencourt, Sergio Tufik
European Respiratory Journal 2018 52: 1701972; DOI: 10.1183/13993003.01972-2017
＜背景＞
閉塞性睡眠時無呼吸(OSA)は心臓代謝疾患と関連している。
しかし、高レベルの身体活動がOSAの頻度、関連する合併症を減少させることができるかは不明である。
＜方法＞
この研究でOSAの頻度と身体活動の関連について検討した。
OSA患者の身体活動が心臓代謝疾患の頻度への保護的効果があるかを８－９年のフォローアップ期間で検討した。
658名のサンパウロ疫学睡眠研究(EPISONO)ボランティアデータを解析した。
２０－８０歳のコホート研究であり、ポリソムノグラフ、国際身体活動質問票、心臓代謝疾患のプロファイルの評価を収集した。
＜結果＞
活動的患者は非活動的な患者よりもOSAのリスクが低かった(relative risk 0.877, 95% CI 0.296–0.855)。
また２型糖尿病も活動的OSA患者ではリスクが少なかった(relative risk 0.493, 95% CI 0.252–0.961)。
代謝量は心臓代謝疾患のマーカーと負の相関があった。
CRP (exp(B)=0.720; p=0.001), interleukin-6 (exp(B)=0.991; p=0.03), インスリン (exp(B)=0.982; p=0.03),
中性脂肪 (exp(B)=0.997; p<0.001), homeostasis model assessment for insulin resistance(HOMA-R) (exp(B)≤0.946; p<0.024),
quantitative insulin sensitivity check index (exp(B)=992.4; p<0.001) , 平均肺動脈圧 (exp(B)=0.987; p=0.001)などである。
＜感想＞
身体活動がアクティブだと２型糖尿病のリスクが低いほか、OSAの発症も少なく、心臓代謝疾患のマーカーも良好だったようです。
Obstructive sleep apnoea (OSA) is positively associated with cardiometabolic diseases; however, high levels of physical activity could decrease the incidence of OSA and associated comorbidities.
In this study we aimed to examine the incidence of OSA in relation to physical activity, and its role as a protective factor in individuals with OSA on the incidence of cardiometabolic diseases, in an 8–9-year follow-up study. We analysed data of 658 volunteers from the São Paulo Epidemiologic Sleep Study (EPISONO), a cohort study of individuals aged 20–80 years, collected through polysomnography, the International Physical Activity Questionnaire and an assessment of cardiometabolic profile.
Active subjects had a lower risk of developing OSA compared with nonactive subjects (relative risk 0.877, 95% CI 0.296–0.855) and there was a reduced risk of developing type 2 diabetes mellitus in active/apnoeic subjects (relative risk 0.493, 95% CI 0.252–0.961) compared with nonactive subjects. Metabolic equivalent was negatively associated to cardiometabolic markers, such as C-reactive protein (exp(B)=0.720; p=0.001), interleukin-6 (exp(B)=0.991; p=0.03), insulin (exp(B)=0.982; p=0.03), triglycerides (exp(B)=0.997; p<0.001), homeostasis model assessment for insulin resistance (exp(B)≤0.946; p<0.024), quantitative insulin sensitivity check index (exp(B)=992.4; p<0.001) and mean arterial pressure (exp(B)=0.987; p=0.001).
Physical activity was a protective factor against type 2 diabetes mellitus in apnoeic individuals; moreover, being active reduced the risk of developing OSA and was associated with a better cardiometabolic profile.