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obstructive sleep apnea aggravates neuroinflammation and pyroptosis in early brain injury following subarachnoid hemorrhage via ASC/HIF-1α pathway

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Neural Regeneration Research 2022年第11期17卷 2537-2543页

作者： Jun Xu Qian Li Chen-Yu Xu Shan Mao Jia-Jia Jin Wei Gu Ying Shi Chun-Fang Zou Liang Ye Department of Respiration Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu ProvinceChina Department of Respiration Nanjing Yuhua HospitalYuhua Branch of Nanjing First HospitalNanjingJiangsu ProvinceChina

obstructive sleep apnea can worsen the prognosis of subarachnoid *** r,the underlying mechanism remains *** this study,we established a mouse model of subarachnoid hemorrhage using the endovascular perforation method and exposed the mice to intermittent hypoxia for 8 hours daily for 2 consecutive days to simulate sleep *** found that sleep apnea aggravated brain edema,increased hippocampal neuron apoptosis,and worsened neurological function in this mouse model of subarachnoid ***,we established an in vitro HT-22 cell model of hemin-induced subarachnoid hemorrhage/intermittent hypoxia and found that the cells died,and lactate dehydrogenase release increased,after 48 *** further investigated the underlying mechanism and found that sleep apnea increased the expression of hippocampal neuroinflammatory factors interleukin-1β,interleukin-18,inte rleukin-6,nuclear factorκB,pyro ptosis-related protein caspase-1,pro-caspase-1,and NLRP3,promoted the prolife ration of astrocytes,and increased the expression of hypoxia-inducible factor 1αand apoptosis-associated speck-like protein containing a CARD,which are the key proteins in the hypoxia-inducible factor 1α/apoptosis-associated speck-like protein containing a CARD signaling *** also found that knockdown of hypoxia-inducible factor 1αexpression in vitro greatly reduced the damage to HY22 *** findings suggest that sleep apnea aggravates early brain injury after subarachnoid hemorrhage by aggravating neuroinflammation and pyroptosis,at least in part through the hypoxia-inducible factor 1α/apoptosis-associated speck-like protein containing a CARD signaling pathway.

关键词： apoptosis associated speck like protein containing a CARD early brain injury hypoxia-inducible factor 1α nucleotide-binding domain and leucine-rich repeat protein 3 obstructive sleep apnea pyroptosis neuroinflammation subarachnoid hemorrhage

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obstructive sleep apnea is associated with severity and long-term prognosis of acute coronary syndrome

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Journal of Geriatric Cardiology 2018年第2期15卷 146-152页

作者： Shuo JIA Yu-Jie ZHOU Yi YU Si-Jing WU Yan SUN Zhi-Jian WANG Xiao-Li LIU Bright Eric King Ying-Xin ZHAO Dong-Mei SHI Yu-Yang LIU Zhi-Ming ZHOU Bejing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Disease Beijing China

Background obstructive sleep apnea （OSA） is a common disease in patients with acute coronary syndrome （ACS） and associated with an increased risk of fatal and nonfatal cardiovascular events. However, most patients in previous study were treated with bare metal stents and the sample sizes were relatively low. The goal of this study was to evaluate the influence of OSA on the severity and prognosis of patients admitted for ACS. Methods In this prospective cohort study, we enrolled patients with ACS who were hospitalized for coronary angiogram/percutaneous coronary intervention and undergone polysomnography. We divided the patients into two groups： moderate to severe OSA group [apnea-hypopnea index （AHI）〉 15 events/h] and control group （AHI ≤ 15 events/h）. They were followed up for up 32 months. Then, we compared the ACS severity and long-term major adverse cardiovascular events （MACE） in patients with different severity of OSA. Results Five hundred and twenty nine patients were included in the final analysis, with 76% of them being men and an average age of 59 ＋ 10 years. The overall mean AHI is 29 ± 19 events/h, 70.5% of them （373/529） being with moderate to severe OSA and 29.5% （156/529） assign into control group. Compared with controls, patients with moderate or severe OSA exhibited a higher prevalence of hypertension as well as higher body mass index, SYNTAX score, Epworth score and length of hospitalization. With a median follow-up duration of 30 months, accumulative rate of MACE was also higher in patients with moderate or severe OSA than that in the control group （8.6% vs. 3.2%, P = 0.028）. After adjusting for baseline confounders by cox regression model, moderate to severe OSA was an independent risk factor of long-term MACE （P = 0.047, HR = 1.618, 95% CI： 1.069-3.869）. Conclusions The results of this study demonstrate that moderate or severe OSA is correlated with disease severity and associated with worse long-term prognosis in ACS patients. The results rai

关键词： Coronary angiogram Coronary artery disease obstructive sleep apnea Outcomes

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obstructive sleep apnea:Overlooked comorbidity in patients with diabetes

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World Journal of Diabetes 2024年第7期15卷 1448-1460页

作者： Eric D Tenda Joshua Henrina Jin H Cha Muhammad R Triono Ersananda A Putri Dahliana J Aristy Dicky L Tahapary Division of Respirology and Critical Care Department of Internal MedicineFaculty of Medicine Universitas Indonesia-Cipto Mangunkusumo HospitalDKI JakartaJakarta Pusat 10430Indonesia Head of Research Group Artificial Intelligence and Digital Health Indonesian Medical Education and Research InstituteFaculty of Medicine University of IndonesiaDKI JakartaJakarta Pusat 10430Indonesia Division of Endocrinology Metabolism and DiabetesDepartment of Internal MedicineFaculty of Medicine Universitas Indonesia-Cipto Mangunkusumo HospitalDKI JakartaJakarta Pusat 10430Indonesia

In this review article,we explore the interplay between obstructive sleep apnea(OSA)and type 2 diabetes mellitus(T2DM),highlighting a significant yet often overlooked *** delve into the pathophysiological links between OSA and diabetes,specifically how OSA exacerbates insulin resistance and disrupts glucose *** research examines the prevalence of OSA in diabetic patients and its role in worsening diabetes-related *** the importance of comprehensive management,including weight control and positive airway pressure therapy,the study advocates integrated approaches to improve outcomes for patients with T2DM and *** review underscores the necessity of recognizing and addressing OSA in diabetes care to ensure more effective treatment and better patient outcomes.

关键词： obstructive sleep apnea Type 2 diabetes mellitus Macrovascular Microvascular Weight loss Positive airway pressure

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Higher ambient temperatures may worsen obstructive sleep apnea:A nationwide smartwatch-based analysis of 6.2 million person-days

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Science Bulletin 2024年第13期69卷 2114-2121页

作者： Anni Li Qingli Zhang Yuan Yao Xinlei Zhu Cong Liu Yutao Guo Haidong Kan Renjie Chen School of Public Health Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology AssessmentFudan UniversityShanghai 200032China Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China Department of Pulmonary Vessel and Thrombotic Disease Sixth Medical CenterChinese PLA General HospitalBeijing 100048China Institute for Hospital Management Research Chinese PLA General HospitalBeijing 100048China Children’s Hospital of Fudan University National Children’s Medical CenterShanghai 201102China School of Public Health Hengyang Medical SchoolUniversity of South ChinaHengyang 421001China

obstructive sleep apnea(OSA)is a serious type of sleep disorder that can lead to cardiometabolic and neurocognitive *** utilized smart device-based photoplethysmography technology to collect sleep data from the Chinese population from 2019 to *** lag nonlinear models combined with a generalized nonlinear model or a linear mixed effects model were used to investigate the shortterm associations between daily temperature and indicators of OSA *** included a total of 6,232,056 d of sleep monitoring data from 51,842 participants with moderate to severe risk of OSA from 313 Chinese *** relationships between ambient temperature and OSA exacerbation,apneahypopnea index(AHI),and minimum oxygen saturation(MinSpO_(2))were almost linear and present only on the same *** temperatures were associated with a greater risk of OSA exacerbation,with an 8.4%(95%confidence interval(CI):7.6%–9.3%)increase per 10℃increase in temperature.A 10℃increase in daily temperature corresponded to an AHI increase of 0.70 events/h(95%CI:0.65–0.76)and a MinSpO_(2)decrease of 0.18%(95%CI:0.16%–0.19%).Exposure to elevated temperatures during the night can also lead to adverse *** effects of higher temperatures on OSA severity were stronger among men,participants with a body mass index24 kg/m2,those aged 45 years and older,individuals with a history of hypertension and diabetes,and during the cold *** large-scale,nationwide,longitudinal study provides robust evidence suggesting that higher ambient temperatures may immediately worsen OSA.

关键词： obstructive sleep apnea Temperature apnea-hypopnea index Oxygen saturation Smart device

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Computational Analysis of Airflow in Upper Airway under Light and Heavy Breathing Conditions for a Realistic Patient Having obstructive sleep apnea

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Computer Modeling in Engineering & Sciences 2021年第8期128卷 583-604页

作者： W.M.Faizal N.N.N.Ghazali C.Y.Khor M.Z.Zainon Irfan Anjum Badruddin Sarfaraz Kamangar Norliza Binti Ibrahim Roziana Mohd Razi Faculty of Mechanical Engineering Technology University Malaysia PerlisPerlisMalaysia Department of Mechanical Engineering Faculty of EngineeringUniversity of MalayaKuala Lumpur50603Malaysia Research Center for Advanced Materials Science King Khalid UniversityAbha61413Saudi Arabia Department of Mechanical Engineering College of EngineeringKing Khalid UniversityAbha61421Saudi Arabia Department of Oral&Maxillofacial Clinical Science Faculty of DentistryUniversity of MalayaKuala Lumpur50603Malaysia Department of Paediatric Dentistry and Orthodontics Faculty of DentistryUniversity of MalayaKuala Lumpur50603Malaysia

Background:obstructive sleep apnea is a sleeping disorder that has troubled a sizeable *** is an active area of research on obstructive sleep apnea that intends to better understand airflow behaviors and therefore treat patients more *** paper aims to investigate the airflow characteristics of the upper airway in an obstructive sleep apnea(OSA)patient under light and heavy breathing conditions by using Turbulent Kinetic Energy(TKE),an accurate method in expressing the flow concentration mechanisms of sleeping *** is important to visualize the concentration of flow in the upper airway in order to identify the severity level of the obstruction during ***:Computational fluid dynamic(CFD)analysis was used as a solution tool to evaluate the airflow during light and heavy breathing conditions.A medical imaging technique was used to extract the 3D model from the CT scan ***,mesh generation and simulation were carried out via CFD software to evaluate the light and heavy breathing characteristics related to obstructive sleep *** state Reynold’s averaged Navier-Stoke(RANS)with the k-ωshear stress transport(SST)turbulence model was *** airflow characteristics were quantified using parameters such as pressure distribution,skin friction coefficient,velocity profile,Reynolds number,turbulent Reynolds number and turbulence kinetic ***:Contour plots at different planes were used to visualize the airflow distribution as it passed through different cross-sectional areas of the *** results revealed that the presence of a smaller cross-sectional area of the airway caused an increase in airflow parameters,especially during heavy ***,turbulent airflow conditions along the airway were noticed during heavy *** severity of OSA could be measured by the turbulent kinetic energy which is able to show the behavior and concentration of mean *** study is expected to p

关键词： Human upper airway computational fluid dynamics obstructive sleep apnea turbulent kinetic energy

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Turbulent Kinetic Energy of Flow during Inhale and Exhale to Characterize the Severity of obstructive sleep apnea Patient

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Computer Modeling in Engineering & Sciences 2023年第7期136卷 43-61页

作者： W.M.Faizal C.Y.Khor Muhammad Nooramin Che Yaakob N.N.N.Ghazali M.Z.Zainon Norliza Binti Ibrahim Roziana Mohd Razi Faculty of Mechanical Engineering&Technology University Malaysia PerlisPadang Besar02100Malaysia Department of Mechanical Engineering Faculty of EngineeringUniversity of MalayaKuala Lumpur50603Malaysia Department of Oral&Maxillofacial Clinical Science Faculty of DentistryUniversity of MalayaKuala Lumpur50603Malaysia Department of Paediatric Dentistry and Orthodontics Faculty of DentistryUniversity of MalayaKuala Lumpur50603Malaysia

This paper aims to investigate and present the numerical investigation of airflow characteristics using Turbulent Kinetic Energy(TKE)to characterize the upper airway with obstructive sleep apnea(OSA)under inhale and exhale breathing *** importance of TKE under both breathing conditions is that it showan accuratemethod in expressing the severity of flow in sleep *** fluid dynamics simulate the upper airway’s airflow via steady-state Reynolds-averaged Navier-Stokes(RANS)with k–ωshear stress transport(SST)*** three-dimensional(3D)airway model is created based on the CT scan images of an actual patient,meshed with 1.29 million elements using Materialise Interactive Medical Image Control System(MIMICS)and ANSYS software,*** TKE were noticed around the region after the necking(smaller cross-sectional area)during the inhale and exhale *** turbulent kinetic energy could be used as a valuablemeasure to identify the severity of *** study is expected to provide a better understanding and clear visualization of the airflow characteristics during the inhale and exhale breathing in the upper airway of patients for medical practitioners in the OSA research field.

关键词： obstructive sleep apnea breathing disorders real patient CFD turbulent kinetic energy

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Effects of obstructive sleep apnea and its treatment over the erectile function： a systematic review

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Asian Journal of Andrology 2017年第3期19卷 303-310页

作者： Felix Campos-Juanatey Marcos Fernandez-Barriales Monica Gonzalez Jose A Portillo-Martin Urology Department Marques de Valdecilla University Hospital Santander 39008 Spain Institute of Investigation Marques de Valdecilla Santander 39011 Spain Oral and Maxillofacial Surgery Department Araba University Hospital Araba 01004 Spain sleep and Ventilation Unit Marques de Valdecilla University Hospital Santander 39008 Spain Medical and Surgical Sciences Department School of Medicine University of Cantabria Santander 39011 Spain.

Erectile dysfunction （ED） is considered a condition with a broad range of etiologies. obstructive sleep apnea （OSA） syndrome is one of the lesser studied risk factors for ED. We intend to summarize the current evidence on the relationship between OSA and sexual impairment, focusing on the results in terms of erectile function of the different therapies offered to OSA patients. A systematic review was conducted, selecting articles related to the physiology of OSA and ED, and to the treatments of OSA syndrome and their reported outcomes in erectile and sexual function. Higher prevalences of ED in the OSA groups have been published. However, whether this effect on the erectile function occurs in the entire range of OSA severities remains unclear. Several hypotheses were proposed to explain the physiology of this association. Continuous Positive Airway Pressure as a treatment for OSA patients with ED has achieved a significative improvement in the sexual parameters in most of the studies. Phosphodiesterase type 5 inhibitors （iPDE5） on demand are useful as a treatment for ED in this subgroup of patients, with high satisfaction rates. The surgical treatment for the OSA evidenced benefits over the erectile function, and the effect on the sexual satisfaction of the therapy using Mandibular Advancement Devices is still undefined.

关键词： continuous positive airway pressure erectile dysfunction obstructive sleep apnea operative surgical procedures phosphodiesterase type 5 inhibitors

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obstructive sleep apnea is associated with impaired glucose metabolism in Han Chinese subjects

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Chinese Medical Journal 2013年第1期126卷 5-10页

作者： GU Chen-juan LI Min LI Qing-yun LI Ning SHI Guo-chao WAN Huan-ying Department of Respiratory Medicine Shanghai Ruijin HospitalShanghai Jiao Tong University School of Medicine Shanghai200025 China

Background Increasingly, evidence from population, clinic-based and laboratory studies supports an independent association between obstructive sleep apnea syndrome （OSAS） and an increased risk of type 2 diabetes; however, this observation has yet to be replicated in China and the potential mechanisms that link these two conditions are not clear. Methods A total of 179 Han Chinese subjects were enrolled in this study. All subjects underwent polysomnography, the oral glucose tolerance-insulin releasing test （OGTT-IRT） and serum HbAlc measurement. Indexes including homeostasis model assessment-IR （HOMA-IR）, Matsuda index, HOMA-β, early phase insulinogenic index （△I30 / △G30）, AUC-I180 and oral disposition index （DIo） were calculated for the assessment of insulin resistance and pancreatic β-cell function. Results Based on OGTT, 25.4%, 44.6% and 54.5% subjects were diagnosed having glucose metabolic disorders respectively in control, mild to moderate and severe OSAS groups （P 〈0.05）. Serum HbA1c levels were highest in subjects with severe OSAS （P 〈0.05）. In contrast, compared with normal subjects, HOMA-β, △I30/△G30 and DIo were lower in severe OSAS group （P 〈0.05）. In stepwise multiple linear regressions, 0-min glucose and HbAlc were positively correlated with the percentage of total sleep time below an oxyhemoglobin saturation of 90% （T90）（Beta = 0.215 and 0.368, P 〈0.05）; 30-min and 60-min glucose was negatively correlated with the lowest SpO2 （LSpO2）（Beta = -0.214 and -0.241, P 〈0.05）. HOMA-β and Dlowere negatively correlated with T90 （Beta = -0.153 and -0.169, P 〈0.05） while body mass index （BMI） was the only determinant of HOMA-IR and Matsuda index. Conclusions OSAS is associated with impairment in glucose tolerance and pancreatic β-cell function in Han Chinese subjects while insulin sensitivity is mainly determined by obesity.

关键词： obstructive sleep apnea glucose metabolism pancreatic β-cell function insulin resistance

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obstructive sleep apnea Affecting Platelet Reactivity in Patients Undergoing Percutaneous Coronary Intervention

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Chinese Medical Journal 2018年第9期131卷 1023-1029页

作者： Xiao-Min Jiang Xue-Song Qian Xiao-Fei Gao Zhen Ge Nai-Liang Tian Jing Kan Jun-Jie Zhang Department of Cardiology Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu 210006 China Department of Cardiology Zhangjiagang First People's Hospital Zhangjiagang Jiangsu 215699 China

Background：The relationship between obstructive sleep apnea （OSA） and platelet reactivity in patients undergoing percutaneous coronary intervention （PCI） has not been *** present prospective,single-center study explored the relationship between platelet reactivity and OSA in patients with ***：A total of 242 patients were finally included in the *** was screened overnight by *** reactivity was assessed with a sequential platelet counting method,and the platelet maximum aggregation ratio （MAR） and average aggregation ratio were *** patients were assigned per apnea-hypopnea index （AHI） to non-OSA （n =128） and OSA （n =l 14） *** receiver operating characteristic curve analysis was used to evaluate the accuracy of AHI for high platelet reactivity （HPR） on aspirin and clopidogrel,and multivariable logistic regression was used to determine the independent predictors of HPR on aspirin and ***：Median AHI was significantly higher in the OSA group than in the non-OSA group （34.5 events/h vs.8.1 events/h,Z =-13.422,P 〈 0.001）.Likewise,median arachidonic acid-and adenosine diphosphate-induced maximum aggregation rate （MAR） in the OSA group was significantly higher than those in the non-OSA group （21.1% vs.17.7%,Z=-3.525,P 〈 0.001 and 45.8% vs.32.2%,Z =-5.708,P 〈 0.001,respectively）.Multivariable logistic regression showed that OSA was the only independent predictor for HPR on aspirin （odds ratio [OR]：1.055,95% confidence interval [CI]：1.033-1.077,P 〈 0.001） and clopidogrel （OR：1.036,95% CI：1.017-1.056,P 〈 0.001）.The cutoffvalue of AHI for HPR on aspirin was 45.2 events/h （sensitivity 47.1% and specificity 91.3%）,whereas cutoffvalue of AHI for HPR on clopidogrel was 21.3 events/h （sensitivity 68.3% and specificity 67.7%）.

关键词： Antiplatelet Drugs Maximum Aggregation Rate obstructive sleep apnea Percutaneous Coronary Intervention Platelet Reactivity

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Association between non-alcoholic fatty liver disease and obstructive sleep apnea

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World Journal of Gastroenterology 2020年第20期26卷 2669-2681页

作者： Ilaria Umbro Valerio Fabiani Mario Fabiani Francesco Angelico Maria Del Ben Department of Anatomical HistologicalForensic Medicine and Orthopedic SciencesSapienza University of RomeRome 00161Italy Department of Neurosciences Mental Health and Sensory OrgansSapienza University of RomeRome 00123Italy Department of Sense Organs Sapienza University of RomeRome 00161Italy Department of Public Health and Infectious Diseases Sapienza University of RomeRome 00161Italy Department of Clinical InternalAnesthetic and Cardiovascular SciencesSapienza University of RomeRome 00161Italy

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is an emerging liver disease and currently the most common cause of incidental abnormal liver *** pathogenesis of NAFLD is multifactorial and many mechanisms that cause fatty liver infiltration,inflammation,oxidative stress and progressive fibrosis have been *** sleep apnea(OSA)may be linked with the pathogenesis and the severity of *** To study the association between NAFLD and OSA considering also the efficacy of continuous positive airway pressure(CPAP)*** A Pub Med search was conducted using the terms"non-alcoholic fatty liver disease AND(obstructive sleep apnea OR obstructive sleep disorders OR sleep apnea)".Research was limited to title/abstract of articles published in English in the last 5 years;animal and child studies,case reports,commentaries,letters,editorials and meeting abstracts were not *** were extracted on a standardized data collection table which included:First author,publication year,country,study design,number of patients involved,diagnosis and severity of OSA,diagnosis of NAFLD,patient characteristics,results of the *** total,132 articles were initially retrieved on Pub Med search and 77 in the last five *** removal of irrelevant studies,13 articles were included in the qualitative *** was a total of 2753 participants across all the studies with a mean age between 42 and 58 *** proportion of males ranged from21%to 87.9%and the mean body mass index ranged from 24.0 to 49.9 kg/*** results of this review showed an increased prevalence of NAFLD in patients with diagnosis of OSA,even in the absence of coexisting comorbidities such as obesity or metabolic ***,the severity of NAFLD is associated with the increase in OSA *** CPAP treatment,although not always decisive,may stabilize or slow NAFLD progression with benefits on metabolic and cardiovascular *** In

关键词： Continuous positive air pressure Non-alcoholic fatty liver disease Nonalcoholic steatohepatitis obstructive sleep apnea obstructive sleep disorders sleep apnea

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