Tıkayıcı Uyku Apne Sendromlu Hastalarda Boyun ve Bel Çevresi Arteriyel İntima Media Kalınlığının Bir Göstergesi Olabilir Mi?

GİRİŞ ve AMAÇ: Karotid ve femoral arter intima media kalınlığı (İMK), vücut kitle indeksi (VKİ) ölçümleri kardiyometabolik risk belirteçleridir. Literatürde tıkayıcı uyku apneli (TUA) hastalarında bu belirteçler tek tek ele alınmış fakat boyun ve bel çevresinin bölgelerindeki arter kalınlıkları üzerinde etkisini inceleyen bir çalışma yapılmamıştır. Çalışmamızın amacı; varsa bu ilişkiyi ortaya koymak ve olası sebeblerini irdelemektir. YÖNTEM ve GEREÇLER: Çalışmamıza toplam 195 hasta ve 50 kontrol hastası alındı. Hastalardan sigara içme, apne, inme, anjina pektoris, kronik böbrek hastalığı, diyabet öyküsü olanlar ve 65 yaş üstü olanlar çalışmadan dışlandılar. Sonografik İMK ölçümleri, yüksek çözünürlüklü B- mod Ultrason (Philips EPIQ 7)’nin lineer probu (8–12 MHz) ile yapıldı. KİMK ölçümleri; sağ arteria carotis communisin posteromedial duvarından, karotid bulbusun 1-3 cm distalinden, plak bulunmayan üç noktadan alındı. Femoral arter İMK ölçümleri de sağ ana femoral arterin arka duvarından ölçüldü. Her iki grupta boyun ve bel çevresi de ölçülüp ayrıca VKI hesaplandı. BULGULAR: TUA grubunda kontrol grubuna kıyasla kİMK, VKİ, boyun çevresi ve bel çevresi ortalamaları yüksek ve istatistiksel olarak anlamlıyken, fİMK değerlerinde fark yoktu. TUA grubunda boyun çevresi ile kİMK ölçümleri arasında pozitif yönlü doğrusal bir ilişki varken, bel çevresi ve fİMK arasında bir ilişki yoktu. TARTIŞMA ve SONUÇ: TUA hastalarının erken değerlendirilmesi, bu hastalığın kardiyovasküler ve serebrovasküler hastalıklar için bağımsız bir risk faktörü olmasından dolayı önemlidir. Bu hastalıklar için öncül olarak kabul edilen karotis IMT kalınlaşmasının, boyun çevresi ve VKİnin zamanında ölçümü gerekli önlemleri almak için zaman sağlayabilir. Ayrıca sadece boyun çevresi ölçümü bile kİMK hakkında bilgi verebilir

Can The Circumferences of Neck and Waist Be As a Predictor of Arterial İntima Media Thickness in The Patients with Obstructive Sleep Apnea Syndrome?

INTRODUCTION: Carotid and femoral artery intima mediathickness (cIMT and fIMT) and body mass index (BMI) havebeen studied individually in patients with obstructive sleepapnea syndrome (OSAS). But no studies have examined theeffect of the neck and waist circumference (NC and WC) onarterial IMT in their region. The aim of our study; to revealthis relationship and the possible causes.METHODS: A total of 245 study subjects were included in thestudy. Patients with a history of smoking, apnea, stroke, anginapectoris, chronic kidney disease, diabetes and those over 65years of age were excluded from the study. Sonographic IMTmeasurements were performed with B-mode Ultrasound(Philips EPIQ 7). CIMT measurements were taken from theposteromedial wall of the right common carotid artery. FIMTmeasurements were also measured from the posterior wall ofthe right main femoral artery. NC and WC were measured andBMI was calculated in both groups.RESULTS: The mean cIMT, BMI, NC and WC weresignificantly higher in the OSAS group, but there was nodifference in the fIMT values. In the OSAS group, there was apositive linear correlation between NC and cIMTmeasurements, whereas there was no correlation between WCand fIMT.DISCUSSION AND CONCLUSION: Early evaluation ofOSAS patients is beneficial because it is an independent riskfactor for cardiovascular and cerebrovascular diseases. Timelymeasurements of cIMT, NC and BMI may provide time fortaking necessary measures for these diseases. In addition, eventhe NC measurement can provide information about cIMT.

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