ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet9737ometendo-9737Research ArticleОригинальные исследованияOriginal paperПредикторы висцерального ожирения у пациентов с синдромом обструктивного апноэ сна и нормальной массой телаPredictors of visceral obesity in normal weight obstructive sleep apnea patientshttps://orcid.org/0000-0002-2847-4422БродовскаяТатьяна ОлеговнаBrodovskayaTatyana O.

кандидат медицинских наук, доцент кафедры поликлинической терапии, ультразвуковой и функциональной диагностики

MD, PhD, docent of the department of polyclinic therapy, ultrasound and functional diagnostics

tbrod80@gmail.comКовинЕгор АндреевичKovinEgor A.

врач ординатор

resident

eakovin@inbox.ruБаженоваОксана ВикторовнаBazhenovaOxana V.

ассистент кафедры поликлинической терапии, ультразвуковой и функциональной диагностики

polyclinic therapy, ultrasound and functional diagnosis chair assistant

roxanaross@yandex.ruhttps://orcid.org/0000-0002-9004-3711ГришинаИрина ФедоровнаGrishinaIrina F.

д.м.н., профессор

MD, PhD, professor

Grishina@edc.nexcom.ruПеретолчинаТатьяна ФедоровнаPeretolchinaTatiana F.

д.м.н., профессор

MD, PhD, professor

2019806@bk.ru<p>ФГБОУ ВО &laquo;Уральский государственный медицинский университет&raquo; Минздрава России; ГБУЗ Свердловской области &laquo;Свердловская областная больница №2</p>Россия<p>Ural State Medical University; Sverdlovsk Regional Hospital №2</p>Russian Federation<p>ФГБОУ ВО &laquo;Уральский государственный медицинский университет&raquo; Минздрава России</p>Россия<p>Ural State Medical University</p>Russian Federation2019160920191622935Copyright &#x00A9; Бродовская Т.О., Ковин Е.А., Баженова О.В., Гришина И.Ф., Перетолчина Т.Ф., 20192019Бродовская Т.О., Ковин Е.А., Баженова О.В., Гришина И.Ф., Перетолчина Т.Ф.Brodovskaya T.O., Kovin E.A., Bazhenova O.V., Grishina I.F., Peretolchina T.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/9737Обоснование

Обоснование. Синдром обструктивного апноэ сна эпидемиологически тесно взаимосвязан с неблагоприятными кардиоваскулярными исходами. В основе патогенеза могут находиться метаболические сдвиги и ожирение. Наиболее изученные антропометрические предикторы ожирения, такие как индекс массы тела (ИМТ), окружность талии (ОТ), подвержены влиянию различных факторов, например, пол, тип конституции, гидратационный баланс, и вызывают определенные сомнения в предикативной перспективе ожирения. Нормальный диапазон значений ИМТ и ОТ ограничивает диагностический поиск метаболических нарушений и висцерального ожирения у пациентов с нарушениями дыхания во сне.

Цель исследования – проанализировать предикторы висцерального ожирения у пациентов с нормальной массой тела и синдромом обструктивного апноэ сна (СОАС).

Методы

Методы. В результате кросс-секционного исследования обследованы 68 пациентов, средний возраст которых составил 38,24±7,4 лет. Основная группа (38 человек) представлена пациентами с СОАС. Группа контроля состоит из практически здоровых лиц без СОАС. Изучены дополнительные маркеры висцерального ожирения, такие как накопление липидных продуктов, индекс висцерального ожирения, индекс конусности, отношение окружности талии к росту.

Результаты

Результаты. В основной группе установлены нарушения метаболизма липидов: повышение уровня триглицеридов на 94%, липидов низкой плотности на 32%, общего холестерина на 10% в сравнении с группой контроля. Получены различия по антропометрическим показателям ожирения: окружность талии 89,6±5,7 см в основной группе была выше, чем в группе контроля 83,7±6,3 см (p=0,024) за счет увеличения висцерального жирового компартмента, о чем свидетельствуют показатели индекса конусности (67,2±7,0 и 59,3±6,2 соответственно, p=0,032) и отношение окружности талии к росту (0,58±0,05 и 0,53±0,04 в основной и контрольной группах соответственно, p=0,041). Выявлены корреляционные взаимосвязи между степенью тяжести синдрома апноэ сна и показателями висцерального ожирения.

Заключение

Заключение. Пациенты с нормальной массой тела и нарушениями дыхания во сне характеризуются избыточным накоплением висцерального жира и могут находиться в зоне повышенного кардиоваскулярного риска. Рекомендуется включение оценки дополнительных маркеров висцерального ожирения у пациентов с нормальной массой тела и СОАС в алгоритмы диспансерного наблюдения.

BACKGROUND

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is epidemiologically related to adverse cardiovascular outcomes. The pathophysiology clues are metabolic changes and obesity. The most studied anthropometric predictors of obesity, such as body mass index (BMI), waist circumference (WC), are influenced by various factors such as sex, type of constitution, hydration balance. The normal range of BMI and WC limits the diagnostic search for metabolic disturbances and visceral obesity in patients with respiratory sleep distress and can lead to increased cardiovascular risks.

AIMS

AIMS: to investigate the visceral obesity predictors in normal weight patients with obstructive sleep apnea syndrome.

MATERIALS AND METHODS

MATERIALS AND METHODS: We had performed а cross-sectional study, 68 patients were examined with mean age of 38.24 ± 7.4 years. The main group (38 individuals) was represented by patients with OSAS. The control group consisted of healthy individuals without OSAS. Alternative markers of visceral obesity, such as lipid accumulation products, visceral obesity index, conicity index have been studied.

RESULTS

RESULTS: In the main group we found different disorders of lipid metabolism such as the increase in triglyceride levels by 94%, low-density lipids by 32%, total cholesterol by 10% compared with the control group. Anthropometric evidence was obtained for excessive fat accumulation in patients with normal body weight and OSAS: WC was 89.6 ± 5.7 cm in the main group and was higher than in the control group 83.7 ± 6.3 cm (p = 0.024) due to an increase in the visceral fat compartment, as evidenced by the conicity index (67.2 ± 7.0 and 59.3 ± 6.2 respectively, p = 0.032) and waist to height ratio (0.58 ± 0.05 and 0.53 ± 0.04 in the main and control groups, respectively, p = 0.041). Correlation relationships between the severity of sleep apnea syndrome and visceral obesity indicators were revealed.

CONCLUSIONS

CONCLUSIONS: Normal weight patients with breathing disorders are at risk of visceral fat obesity and, thereby, increased cardiovascular risk. Assessment of additional markers of visceral obesity in patients with normal body weight and sleep apnea is recommended to include in the dynamic observation programms.

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The authors declare that there are no conflicts of interest present.