文献类型：期刊文献

英文题名：Association between Serum Cystatin C levels and long-term cardiovascular outcomes and all-cause mortality in older patients with obstructive sleep apnea

作者：Li, Jian-Hua[1,2];Gao, Ying-Hui[3];Xue, Xin[4];Su, Xiao-Feng[5];Wang, Huan-Huan[5];Lin, Jun-Ling[6];Zhao, Li-Bo[1,2];Zou, Xiao[1,2];Gao, Yan[7];Guo, Jing-Jing[8];Shi, Min[2,9];Xu, Wei-Hao[1,2];Wang, Ya-Bin[1,2];Qian, Xiao-Shun[2,9];Chen, Kai-Bing[10];Fan, Li[1,2];Liu, Lin[2,9]

第一作者：Li, Jian-Hua

通信作者：Fan, L[1];Fan, L[2];Liu, L[2];Liu, L[3];Chen, KB[4]

机构：[1]Chinese Peoples Liberat Army Gen Hosp, Med Ctr 2, Cardiol Dept, Beijing, Peoples R China;[2]Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing, Peoples R China;[3]Peking Univ Int Hosp, PKU UPenn Sleep Ctr, Beijing, Peoples R China;[4]Yanan Univ, Affiliated Hosp, Dept Resp, Yanan, Peoples R China;[5]Yanan Univ, Med Coll, Yanan, Peoples R China;[6]Capital Med Univ, Beijing Chaoyang Hosp, Dept Resp & Crit Care Med, Beijing, Peoples R China;[7]PLA, Hosp 960, Dept Gen Practice, Jinan, Peoples R China;[8]Peking Univ Peoples Hosp, Sleep Med Ctr, Dept Resp & Crit Care Med, Beijing, Peoples R China;[9]Chinese Peoples Liberat Army Gen Hosp, Med Ctr 2, Dept Resp & Crit Care Med, Beijing, Peoples R China;[10]Gansu Univ Chinese Med, Affiliated Hosp, Sleep Ctr, Lanzhou, Peoples R China

第一机构：Chinese Peoples Liberat Army Gen Hosp, Med Ctr 2, Cardiol Dept, Beijing, Peoples R China

通信机构：[1]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Med Ctr 2, Cardiol Dept, Beijing, Peoples R China;[2]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Natl Clin Res Ctr Geriatr Dis, Beijing, Peoples R China;[3]corresponding author), Chinese Peoples Liberat Army Gen Hosp, Med Ctr 2, Dept Resp & Crit Care Med, Beijing, Peoples R China;[4]corresponding author), Gansu Univ Chinese Med, Affiliated Hosp, Sleep Ctr, Lanzhou, Peoples R China.|[10735b845793de6ae2b30]甘肃中医药大学第二附属医院;[10735]甘肃中医药大学;

年份：2022

卷号：13

外文期刊名：FRONTIERS IN PHYSIOLOGY

收录：;WOS:【SCI-EXPANDED(收录号:WOS:000890349400001)】；

语种：英文

外文关键词：obstructive sleep apnea; cystatin C; cardiovascular outcomes; mortality; older

摘要：Background and Aims: To investigate the association between obstructive sleep apnea (OSA) severity and baseline serum cystatin C (Cys-C) concentration and to explore the association between baseline serum Cys-C and long-term cardiovascular outcomes and mortality in older patients with OSA. Methods: Between January 2015 and October 2017, a total of 1107 consecutive eligible older patients (60 years) with OSA were included in this multicenter, prospective cohort study, and baseline demographics, clinical characteristics, sleep parameters, and follow-up outcomes were collected. Participants were divided into different groups based on baseline serum Cys-C levels. The primary end point was major adverse cardiovascular events (MACE) and the secondary end point was all-cause mortality. The correlation between OSA severity and baseline serum Cys-C was evaluated by Spearman correlation analysis. Multivariate Cox regression was used to analyze the association between Cys-C and the incidence of MACE and mortality. Results: Participants included 672 men and 435 women, with a median age of 66 (range, 60 -96) years. At baseline, apnea-hypopnea index (AHI) (r = 0.128, p < 0.05), oxygen desaturation index (ODI) (r = 0.116, p < 0.05), and the lowest pulse oxygen saturation (LSpO(2)) (r = -0.097, p < 0.05) were correlated with serum Cys-C concentration. During the median follow-up period of 42 months, 97 patients (8.8%) experienced MACE and 40 patients (3.6%) experienced death. The association between serum Cys-C levels and the risk of MACE and all-cause mortality was slow rising shaped. The multivariable Cox regression analysis showed patients with a serum Cys-C concentration of a14 mg/L had higher risks of MACE (HR = 5.30, 95% CI: 2.28-12.30, p < 0.05) and all-cause mortality (HR = 9.66, 95% CI: 2.09-44.72, p < 0.05) compared with patients with serum Cys-C of 0.81 mg/L in older patients with OSA. The receiver-operating characteristic curve showed baseline serum Cys-C levels exhibited moderately capable of identifying patients with a long-term risk of clinical adverse events (MACE and mortality). Conclusion: OSA severity was positively correlated with serum Cys-C concentration. High levels of Cys-C were independently associated with increased risks of MACE and all-cause mortality in older patients with OSA, suggesting that lowering Cys-C levels should be considered as a therapeutic target, and monitoring serum Cys-C may be beneficial to the favorable prognosis of older patients with OSA.