Study On The Correlation Between Obstructive Sleep Apnea Hypopnea Syndrome And Its Risk Factors With White Matter Lesions

ObjectiveStudy on the correlation between obstructive sleep apnea hypopnea syndrome and its risk factors with white matter lesions.Methods and materials1.Object of studyPatients were enrolled in the hospital and have an MRI and polysomnography monitoring between May 2015 and March 2019 were included in our study.According to the inclusion and exclusion criteria,a total of 172 consecutive individuals were enrolled in our study.2.Data collection2.1 Clinical dataThe data was recorded including:age,gender,BMI,hypertention,diabetes,blood lipids.2.2 Sleep monitoring dataSaO2<90%time/total sleep time(TSTSaO2<90%),lowest oxygen saturation level(LSaO2).2.3 Imaging data collectionFazekas scale was used to measure the the white matter hypertensities.3.Statistical analysis3.1 It is Divided non-OSAHS group,mild OSAHS group,moderate to severe OSAHS group according to AHI.ANOVA was used Used to compare differences of LSa02,TSTSaO2<90%,BMI and AHI in different body position between the Severity of OSAHS groups.3.2 T-test was used in comparison of measurement data,Chi-squared test was used in comparison of categorical data.The factors statistically significant in univariate analysis(P<0.05)were included as independent variable,WML were included as dependent variable,binary logsistic analysis was used to analyze independent risk factors of WML.3.3 Severity of OSAHS was included as dependent variable,Chi-squared test was used to compare Prevalence of WML between different severity groups of OSAHS.3.4 Spearman correlation analysis was used to evaluate respectively the association between LSa02 and WML,TSTSaO2<90%and WML,BMI and WML,AHI in different body position and WML.3.5 AHI in different body position in WML group and non-WML group were further analyzed.Results1.Lsa02 in the non-OSAHS group,the mild OSAHS group,and the moderate-to-severe OSAHS group showed a decreasing trend.TSTSaO2<90%showed an increasing trend,body mass index showed an increasing trend.In Severity of OSAHS groups,the AHI in supine position were significantly higher than that in the left or right lateral position,and the difference between the left and right lateral position was not significant(P>0.05).2.The resultes of binary logsistic analysis for the WMLAccording to the univariate analysis,the independent variables of P<0.1,were included in the multivariate logistic regression model.After adjusting for confounding factors,the two-category logistic regression showed that age(ORF=1.154,95%CI:1.099-1.211,P<0.001),gender(OR=4.442,95%CI:0.506-3.027,P=0.019),OSAHS(OR =8.347,95%CI:2.561～27.212,P<0.001)were independent risk factors for WML.The prevalence of WML increased with the severity of OSAHS(P=0.002).3.Correlation between factors affecting the severity of OSAHS and white matter degenerationSpearman correlation analysis showed that WML was positively related to TSTSa02<90%(r=0.170,P=0.042),AHI in supine position(r=0.209,P=0.006),respectively.4.Comparison of AHI in different sleep positions between WML group and patients without WMLThe AHI in supine position of WML patients was higher than that in the non-WML(17.23±17.83 vs.25.69±20.34,P=0.006),and the AHI in the left or right lateral position were significantly lower er than that in supine position of the two groups(P<0.05),and the difference between the left and right lateral position was not significant(P>0.05).Conclusions1.Age,OSAHS were an independent risk factor for WML.The prevalence of WML increased with the severity of OSAHS.The severity of OSAHS was positively related to TSTSaO2<90%.In Severity of OSAHS groups,the AHI in supine position were significantly higher than that in the lateral position,and WML was positively related to TSTSaO2<90%,AHI in supine position,respectively.2.The AHI in supine position of WML patients was higher than that in the non-WML,and the AHI in the left or right lateral position were significantly lower er than that in supine position of the two groups.The lateral position is more effective than the supine position in reducing the number of apneas or hypopneas.