Asiye KANBAY, Ercan MADENCİ, Aylin PIHTILI, Handan İNÖNÜ KÖSEOĞLU, Selcan TULU, Johan VERBRAECKEN, Erkan CEYLAN, Oğuz KÖKTÜRK

Obstrüktif uyku apnesi osteoartrit için risk faktörüdür

Giriş: Obstrüktif uyku apne ile kardiyovasküler hastalıklar ve metabolik bozukluklar arasında sıkı ilişki vardır. Yapılan araştırmalar osteoartrit ile kardiyovasküler hastalık ve inflamasyon arasında da ilişki olduğunu göstermiştir. Bu çalışmada direkt grafi ile sınıflandırılmış osteoartrit ile obstrüktif uyku apnenin ağırlığı arasındaki ilişki araştırılmıştır. Materyal ve Metod: Bu kesitsel çalışmaya obstrüktif uyku apne şüphesi ile polisomnografi yapılan hastalar dahil edildi. Apne hipopne indeksi (AHİ)’ne göre hastalar hafif (AHİ= 5-14.9), orta (AHİ= 15-29.9), ağır (AHİ ≥ 30) ve kontrol (AHİ < 5) grubu olarak sınıflandırıldı. Osteoartrit ağırlığı Kellgren-Lawrence skorlama sitemi kullanılarak evre 1, 2, 3 ve 4 olarak sınıflandırıldı. Gereç ve Yöntem: Çalışmaya 120 hasta dahil edildi. Hastaların ortalama yaşı 52.4 ± 11.5 yıl olup; hastaların %56 (68/120)’sı erkek olarak tespit edildi. Obstrüktif uyku apnenin ciddiyeti ile osteoartritin ciddiyeti arasında sıkı bir ilişki saptandı. Ağır osteoartriti (evre 4) olan tüm hastaların (33 hasta) ağır obstrüktif uyku apne hastalığı olduğu ve bu ilişkinin beden kitle indeksinden bağımsız olduğu tespit edildi. Hafif evre osteoartrit olan hastaların hiçbirinde obstrüktif uyku apne hastalığı olmadığı saptandı (p< 0.05). Osteoartrit, obstrüktif uyku apne hastalığı ve C-reaktif protein (CRP) arasında sıkı ilişki gözlendi. Bulgular: Obstrüktif uyku apne osteoartrit gelişmesi için bir risk faktörü olabilir. Obstrüktik uyku apne hastalığı tedavisinin osteoartrit üzerine etkisi ile ilgili yeni çalışmalara ihtiyaç vardır.

Obstructive sleep apnea is a risk factor for osteoarthritis

Introduction: Obstructive sleep apnea (OSA) syndrome is closelyassociated with cardiovascular and metabolic disorders. Recentstudies reported that osteoarthritis (OA) is associated withcardiovascular disease as well as inflammation defined as“metabolic disorder”. Due to the strong association of metabolic disorders with both OA and OSA, we aimed to investigate the association between severity of OSA and osteoarthritis grade basedon X-Ray.Materials and Methods: Patients who underwent polysomnography due to suspicion of OSA were recruited in a cross-sectional study.Included patients were grouped according to apnea-hypopnea index (AHI) as mild (AHI between 5 and 14.9), moderately (AHIbetween 15 and 29.9), and severe OSA (AHI ≥ 30). Patients with AHI < 5 served as the control group. Kellgren-Lawrence scoringsystem was used to express OA severity, which was graded as Grade 0, 1, 2, 3 and 4.Results: One hundred twenty patients were enrolled into the study. Mean age was 52.4 ± 11.5 years and 56% (68/120) of thepatients were male. A strong correlation was present between severity of OSA and severity of OA. Among those with Grade 4 OAgroup (33 patients), all patients had severe OSA and this association was independent from body-mass index. In the Grade 1 OAgroup, none of the patients had severe OSA (p< 0.05). A positive correlation was also seen between severity of OSA, OA and hs-CRP.Conclusion: There is a strong association between OSA and OA. OSA might be a novel risk factor for the development OA. Furtherstudies should evaluate the effect of OSA treatment on OA.

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