Predictors for carotid and femoral artery intima-media thickness in a non-diabetic sleep clinic cohort.
<h4>Introduction</h4>The impact of sleep disordered breathing (SDB) on arterial intima-media thickness (IMT), a surrogate measure for cardiovascular disease, remains uncertain, in part because of the potential for non-SDB vascular risk factor interactions. In the present study, we determ...
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oai:doaj.org-article:9794565327914e0786370cdc73da88002021-12-02T20:07:15ZPredictors for carotid and femoral artery intima-media thickness in a non-diabetic sleep clinic cohort.1932-620310.1371/journal.pone.0252569https://doaj.org/article/9794565327914e0786370cdc73da88002021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252569https://doaj.org/toc/1932-6203<h4>Introduction</h4>The impact of sleep disordered breathing (SDB) on arterial intima-media thickness (IMT), a surrogate measure for cardiovascular disease, remains uncertain, in part because of the potential for non-SDB vascular risk factor interactions. In the present study, we determined predictors for common carotid (CCA) and femoral (CFA) artery IMT in an adult, sleep clinic cohort where non-SDB vascular risk factors (particularly diabetes) were eliminated or controlled.<h4>Methods</h4>We recruited 296 participants for polysomnography (standard SDB severity metrics) and CCA/CFA ultrasound examinations, followed by a 12 month vascular risk factor minimisation (RFM) and continuous positive pressure (CPAP) intervention for participants with a range of SDB severity (RFM Sub-Group, n = 157; apnea hyponea index [AHI]: 14.7 (7.2-33.2), median [IQR]). Univariable and multivariable linear regression models determined independent predictors for IMT. Linear mixed effects modelling determined independent predictors for IMT change across the intervention study. P<0.05 was considered significant.<h4>Results</h4>Age, systolic blood pressure and waist:hip ratio were identified as non-SDB predictive factors for CCA IMT and age, weight and total cholesterol:HDL ratio for CFA IMT. No SDB severity metric emerged as an independent predictor for either CCA or CFA IMT, except in the RFM Sub-Group, where a 2-fold increase in AHI predicted a 2.4% increase in CFA IMT. Across the intervention study, CCA IMT decreased in those who lost weight, but there was no CPAP use interaction. CFA IMT, however, decreased by 12.9% (95%CI 6.8, 18.7%, p = 0.001) in those participants who both lost weight and used CPAP > = 4hours/night.<h4>Conclusion</h4>We conclude that SDB severity has little impact on CCA IMT values when non-SDB vascular risk factors are minimised or not present. This is the first study, however, to suggest a potential linkage between SDB severity and CFA IMT values.<h4>Trial registration</h4>Australian New Zealand Clinical Trials Registry, ACTRN12611000250932 and ACTRN12620000694910.Christopher LambethRita PerriSharon LeeManisha VermaNicole Campbell-RogersGeorge LarcosKaren BythKristina KairaitisTerence AmisJohn WheatleyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252569 (2021) |
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Medicine R Science Q Christopher Lambeth Rita Perri Sharon Lee Manisha Verma Nicole Campbell-Rogers George Larcos Karen Byth Kristina Kairaitis Terence Amis John Wheatley Predictors for carotid and femoral artery intima-media thickness in a non-diabetic sleep clinic cohort. |
| description |
<h4>Introduction</h4>The impact of sleep disordered breathing (SDB) on arterial intima-media thickness (IMT), a surrogate measure for cardiovascular disease, remains uncertain, in part because of the potential for non-SDB vascular risk factor interactions. In the present study, we determined predictors for common carotid (CCA) and femoral (CFA) artery IMT in an adult, sleep clinic cohort where non-SDB vascular risk factors (particularly diabetes) were eliminated or controlled.<h4>Methods</h4>We recruited 296 participants for polysomnography (standard SDB severity metrics) and CCA/CFA ultrasound examinations, followed by a 12 month vascular risk factor minimisation (RFM) and continuous positive pressure (CPAP) intervention for participants with a range of SDB severity (RFM Sub-Group, n = 157; apnea hyponea index [AHI]: 14.7 (7.2-33.2), median [IQR]). Univariable and multivariable linear regression models determined independent predictors for IMT. Linear mixed effects modelling determined independent predictors for IMT change across the intervention study. P<0.05 was considered significant.<h4>Results</h4>Age, systolic blood pressure and waist:hip ratio were identified as non-SDB predictive factors for CCA IMT and age, weight and total cholesterol:HDL ratio for CFA IMT. No SDB severity metric emerged as an independent predictor for either CCA or CFA IMT, except in the RFM Sub-Group, where a 2-fold increase in AHI predicted a 2.4% increase in CFA IMT. Across the intervention study, CCA IMT decreased in those who lost weight, but there was no CPAP use interaction. CFA IMT, however, decreased by 12.9% (95%CI 6.8, 18.7%, p = 0.001) in those participants who both lost weight and used CPAP > = 4hours/night.<h4>Conclusion</h4>We conclude that SDB severity has little impact on CCA IMT values when non-SDB vascular risk factors are minimised or not present. This is the first study, however, to suggest a potential linkage between SDB severity and CFA IMT values.<h4>Trial registration</h4>Australian New Zealand Clinical Trials Registry, ACTRN12611000250932 and ACTRN12620000694910. |
| format |
article |
| author |
Christopher Lambeth Rita Perri Sharon Lee Manisha Verma Nicole Campbell-Rogers George Larcos Karen Byth Kristina Kairaitis Terence Amis John Wheatley |
| author_facet |
Christopher Lambeth Rita Perri Sharon Lee Manisha Verma Nicole Campbell-Rogers George Larcos Karen Byth Kristina Kairaitis Terence Amis John Wheatley |
| author_sort |
Christopher Lambeth |
| title |
Predictors for carotid and femoral artery intima-media thickness in a non-diabetic sleep clinic cohort. |
| title_short |
Predictors for carotid and femoral artery intima-media thickness in a non-diabetic sleep clinic cohort. |
| title_full |
Predictors for carotid and femoral artery intima-media thickness in a non-diabetic sleep clinic cohort. |
| title_fullStr |
Predictors for carotid and femoral artery intima-media thickness in a non-diabetic sleep clinic cohort. |
| title_full_unstemmed |
Predictors for carotid and femoral artery intima-media thickness in a non-diabetic sleep clinic cohort. |
| title_sort |
predictors for carotid and femoral artery intima-media thickness in a non-diabetic sleep clinic cohort. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/9794565327914e0786370cdc73da8800 |
| work_keys_str_mv |
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