Obstructive Sleep Apnea Syndrome Causes Vascular Dysfunction, Similarly with Diabetes Mellitus

Abstract

subjects, Abstract Background: The mechanisms of cardiovascular adverse events in Obstructive Sleep Apnea Syndrome (OSAS) are not fully clarified, but vascular dysfunction plays a key role. However, the protocols for assessing vascular function are heterogenous and there are new vascular function parameters that could emerge into practice. Methods: The vascular function was assessed through Intima Media-Thickness (IMT), “e-tracking” and “wave intensity” technologies in 60 subjects (55±12 years, 9 women): 20 patients with moderate to severe OSAS (mean apnea-hypopnea index 43±23) without diabetes; 20 patients with type 2 Diabetes Mellitus (DM), and 20 control, normal subjects (C), age, gender and cardiovascular risk factors matched. Results: IMT in OSAS and DM groups were similar, but statistically higher compared to C group. Arterial stiffness parameters, like Peterson’s pressure-strain elastic modulus (Ep), beta stiffness index (β), Arterial Compliance (AC), First Systolic Peak (FP), and second Systolic Peak (SP) were similar between OSAS and DM group, but significantly affected compared to C group. Endothelial dysfunction quantified through Flow Mediated Dilation (FMD) was similar in the OSAS and DM groups and statistically significant lower compared to control group. Conclusion: Patients with moderate to severe OSAS have increased vascular remodeling, vascular stiffness and endothelial dysfunction, with similar vascular profile with patients with DM, suggesting that OSAS should be considered a disease associated with a high cardiovascular risk.