This study compares the carotid intima-media thickness (CIMT) in different severity of obstructive sleep apnea (OSA) patients, and assesses the role of OSA in carotid artery vasculopathy with control of multiple co-morbidities.
Prospective case-control study
Tertiary referral center
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.
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.
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.
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