Evaluation Of Carotid Elasticity In Patients With Obstructive Sleep Apnea Hypopnea Syndrome And Type 2 Diabetes Mellitus By Ultrafast Pulse Wave Velocity Technique

ObjectiveThe aim of this research was to investigate the elastic function of carotid artery quantificationally in patients with obstructive sleep apnea hypopnea syndrome?OSAHS?combined with type 2 diabetes mellitus?T2DM?by ultrafast pulse wave velocity?UFPWV?technique,and to explore its clinical practice value.MethodsSelected during the period of December 2017 and December 2018 in our hospital diagnosis of OSAHS patients,T2DM patients,and OSAHS combined with T2DM patients randomly,both in the short term for carotid artery ultrasound,the patients with carotid intima-media thickness thickening and carotid plaque were excluded,screening and retaining image quality is quite well in each group of 30 cases,divided into OSAHS group,T2DM group and OSAHS + T2DM group;In addition,30 healthy volunteers were selected as the control group.The gender and age of subjects in each group were matched to avoid selective bias.Ultrafast pulse wave velocity technique is used to measure the following parameters,including pulse wave velocity at beginning of systole(PWV_BS)and pulse wave velocity at end of systole(PWV_ES).Comparing the difference between each group with PWV_BS and PWV_ES,and the clinical indicators were collected such as gender,age,fasting plasma glucose,body mass index,apnea hypopnea index.Analyze the correlations between the risk factors of arteriosclerosis and the elastic parameters.IBM SPSS Statistics 23.0 was used to process the data,a two tailed P<0.05 demonstrated statistical significance.Results1.Comparison of basic clinical data between the four groupsThere was no significant difference in gender,heart rate and age between groups?P>0.05?.And systolic blood pressure?SBP?,diastolic blood pressure?DBP?,fasting plasma glucose?FPG?,apnea hypopnea index?AHI?,body mass index?BMI?,lowest arterial oxygen saturation?LSaO₂?,mean arterial oxygen saturation?MSaO₂?and triglyceride?TG?,low-density lipoprotein cholesterol?LDL-C?and high-density lipoprotein cholesterol?HDL-C?was statistically significant?P <0.05?.2.Comparison between PWV_BS and PWV_ES in the left and right sides of each groupPWV_BS and PWV_ES of the left and right carotid arteries in each group showed no statistical significance?P>0.05?.3.Comparison of PWV_BS and PWV_ES among different gendersThe comparison of PWV_BS and PWV_ES in carotid artery between different genders showed no statistical significance?P>0.05?.4.Comparison of PWV_BS and PWV_ES among groups?1?Compared with the control group,the PWV_BS and PWV_ES of OSAHS group,T2DM group and OSAHS+T2DM group were higher than the control group,and the difference was statistically significant?P<0.05?.?2?Compared with OSAHS group,the PWV_BS and PWV_ES of OSAHS+T2DM group were higher than OSAHS group,and the difference was statistically significant?P<0.05?.?3?Compared with T2DM group,PWV_BS and PWV_ES of OSAHS+T2DM group were higher than T2DM group,and the difference was statistically significant?P<0.05?.5.Sensitivity and specificity of PWV_BS and PWV_ES?1?The critical value of PWV_BS is 6.17m/s,with a sensitivity of 76.7% and a specificity of 81.1%.?2?The critical value of PWV_ES is 7.62m/s,with a sensitivity of 79.6% and a specificity of 72.2%.6.Correlation between the elastic parameters of PWV_BS and PWV_ES and clinical data?1?Age,SBP,DBP,FPG,BMI,AHI,TG,and LDL-C were positively correlated with PWV_BS,and r value were 0.410,0.461,0.457,0.525,0.581,0.650,0.613,and 0.529,respectively?P<0.05?.LSaO₂,MSaO₂,and HDL-C were negatively correlated with PWV_BS,and r value were-0.621,-0.586,and-0.579,respectively?P<0.05?.?2?Age,SBP,DBP,FPG,BMI,AHI,TG,and LDL-C were positively correlated with PWV_ES,and r value were 0.462,0.464,0.439,0.481,0.536,0.569,0.536,and 0.509,respectively?P<0.05?.While LSaO₂,MSaO₂,and HDL-C were negatively correlated with PWV_ES,and r value were-0.522,-0.541,and-0.560,respectively?P<0.05?.7.Analysis of influencing factors of PWV_BS and PWV_ES?1?The factors affecting PWV_BS were age,FPG,AHI,LDL-C and HDL-C,and the beta coefficients were 0.200,0.147,0.282,0.162 and-0.236 respectively?P<0.05?.?2?The factors affecting PWV_ES were age,FPG,AHI,LDL-C and HDL-C,and the beta coefficients were 0.237,0.183,0.310,0.167,and-0.214 respectively?P<0.05?.Conclusions1.The compliance of carotid artery elastic function in OSAHS patients and T2DM patients has been reduced before the change of carotid artery structure and morphology,and the reduction is more obvious in patients combined with OSAHS patients and T2DM patients.2.PWV_BS and PWV_ES,as the elastic parameters of carotid artery,have a good correlation with the risk factors of atherosclerosis in the evaluation of the elastic function of carotid artery,which is expected to become a convenient and reliable new method for the quantitative evaluation of carotid artery elastic function in clinical practice.