[Association between hypothyroidism and sleep breathing disorders in patients with coronary heart disease].

Objective: To explore the association between hypothyroidism and sleep breathing disorders in patients with coronary heart disease (CHD). Methods: A total of 784 patients with CHD were consecutively enrolled at the Emergency & Critical Care Center of Beijing Anzhen Hospital from June 2015 to May 2017. According to thyroid function test results, patients were divided into hypothyroidism group (79 cases) and non-hypothyroidism group (705 cases). All patients had undergone sleep monitoring. The sleep apnea status was compared between the two groups. Multivariate logistic regression and linear regression models were used to analyze the association between hypothyroidism and sleep breathing disorders in patients with CHD. Results: The proportion of females, mean body weight and body mass index in the hypothyroidism group were higher than those in the non-hypothyroidism group [26.6% vs.16.2%, (78.6±11.6) kg vs. (75.7±12.0) kg, (27.7±3.2) kg/m(2) vs. (26.6±3.5) kg/m(2), all P<0.05]. Patients in hypothyroidism group had a decreased average oxygen saturation (SaO(2)) compared with patients in non-hypothyroidism group [ (93.2±2.9) % vs. (93.9±2.0) %, P=0.030]. In addition, events of hypoventilation in hypothyroidism group were significantly higher than those in non-hypothyroidism group[92.5 (45.8, 758.3) times vs. 68.0 (33.0, 125.0) times, P=0.013]. There were no significant differences in apnea hypopnea index, diagnosis of obstructive sleep apnea and other sleep breathing parameters between the two groups (P>0.05). A multiple linear regression analysis found that in patients with CHD, the correlation between hypothyroidism and average sleep SaO(2) was significant (β=-0.508, 95%CI -0.989--0.026, P=0.039). Conclusions: CHD patients with hypothyroidism had a lower sleep average SaO(2), and a higher sleep hypopnea events. There is a correlation between hypothyroidism and sleep hypoxia in patients with CHD. Clinical trial registration: clinicalTrials.gov, NCT03362385.目的： 探讨冠心病患者甲状腺功能减退症（简称甲减）与睡眠呼吸障碍的相关性。 方法： 连续纳入2015年6月至2017年5月间就诊于首都医科大学附属北京安贞医院急诊危重症中心明确诊断为冠心病并进行了睡眠呼吸监测和甲状腺功能检测的患者784例。分为甲减组（79例）和非甲减组（705例）。分别比较两组患者的睡眠呼吸障碍相关指标的差异，并利用多元logistic回归分析及线性回归分析甲减与睡眠呼吸障碍的相关性。 结果： 甲减组女性占比、体重及体重指数均高于非甲减组[26.6%比16.2%、（78.6±11.6）kg比（75.7±12.0）kg、（27.7±3.2）kg/m(2)比（26.6±3.5）kg/m(2)，P值均<0.05]。比较两组睡眠监测结果发现，甲减组睡眠平均血氧饱和度（SaO(2)）较非甲减组低[（93.2±2.9）%比（93.9±2.0）%，P=0.030]。此外，甲减组睡眠低通气事件次数较非甲减组多[92.5（45.8,758.3）次比68.0（33.0,125.0）次，P=0.013]。而两组间睡眠呼吸暂停低通气指数、诊断阻塞性睡眠呼吸暂停的例数及其他睡眠呼吸参数差异无统计学意义（P值均>0.05）。多因素线性回归结果显示，甲减与患者夜间平均SaO(2)具有相关性（β=-0.508，95%CI -0.989~-0.026，P=0.039）。 结论： 在冠心病患者中，甲减患者睡眠平均SaO(2)较低，并且夜间低通气次数更多。冠心病患者甲减与夜间低氧具有一定的相关性。 临床试验注册： clinicalTrials.gov，NCT03362385。.