Obstructive sleep apnea hypopnea syndrome (OSAHS), whose morbidity rate is annually increasing, is mainly manifested as sleep structure disorder, drowsiness, breath blockage, apnea, snoring, etc. (1), which increases the risks of cardiovascular complications and multiple organ damage in patients. OSAHS not only harms the respiratory system but also affects the cardio-cerebrovascular system of patients, and causes such complications as heart failure and coronary heart disease (CHD), seriously affecting the quality of life and lifespan of patients (2, 3). OSAHS has a high morbidity rate in middle-aged and elderly people, and it is also affected by genetics, unhealthy living habits, and social pressure (4). CHD is caused by the myocardial tissue lesions due to stenosis or obstruction of the arterial lumen (5). CHD has become a common cardio-cerebrovascular disease in recent years, and it frequently occurs in the elderly, but patients have become increasingly younger nowadays, with an increasing annual morbidity rate (6). The etiology of CHD is complex, and the effective prevention and control of its risk factors has an important significance to reduce its morbidity rate (7). CHD seriously threatens human health; thus, it has gradually attracted widespread attention in society (8). According to a large number of studies in China and other countries, OSAHS is closely related to CHD (9). Studies have also shown that the morbidity rate of OSAHS in CHD patients is higher than that in the general population, and OSAHS complicated with CHD will raise the mortality rate (10). Therefore, this paper conducted a questionnaire survey of patients with CHD, measured somatic indexes, and detected polysomnography (PSG), insulin, glucose and lipid metabolism parameters, and serum inflammatory factors, so as to analyze the expression differences in inflammatory factors, and glucose and lipid metabolism in patients with OSAHS complicated with CHD. Insulin resistance (HOMA-IR) was evaluated by obesity rate and a homeostasis model to explore the relationship between OSAHS combined with CHD and inflammatory factors, glucose and lipid metabolism, obesity, and IR of cardiovascular disease.

There are at least over 50 million patients with OSAHS in China, and most of them receive no active and effective treatment. On the one hand, patients regard “snoring” as a normal phenomenon rather than a disease. On the other hand, there is still a lack of effective biological indexes for early detection of OSAHS-related complications currently (11–14). Therefore, raising the patient’s awareness of the disease and its complications, and strengthening the early detection of OSAHS-related complications contribute to the treatment of disease and improvement of the prognosis of patients (15). The pathogenesis of OSAHS is upper airway obstruction (16), and OSAHS patients have neurohumoral abnormality (17). OSAHS can cause lesions in the cardiovascular system, and different types of CHD and OSAHS can also promote each other; thus, there is a complicated pathophysiological relation between OSAHS and CHD (18).

In the present study, body weight, BMI, waist circumference, and ESS score were all significantly increased in the OSAHS + CHD group compared with those in the OSAHS group, and the differences were statistically significant (p < 0.05). MAI, TAT, AHI, CT90%, ODI, LSaO₂, and MSaO₂ had obvious differences between the OSAHS + CHD group and the OSAHS group (p < 0.05). There were no obvious differences in the FPG, TC, HDL, and LDL between the OSAHS + CHD group and the OSAHS group (p > 0.05). Compared with the OSAHS group, the OSAHS + CHD group had an obviously increased level of TG, and there was a statistically significant difference (p < 0.05). To sum up, OSAHS has a significant correlation with obesity. OSAHS patients have such symptoms as daytime sleepiness, greasy food preference, and fat accumulation, which will aggravate the obesity of patients. The number of obesity patients with OSAHS + CHD is remarkably larger than those with OSAHS. Therefore, increasing the amount of exercise and reducing the intake of excessive high-calorie food can effectively improve the symptoms of OSAHS. In this study, among the glycolipid metabolism parameters, only TG had obvious changes in OSAHS + CHD compared with OSAHS, but no remarkable changes were observed in other parameters. Such a result is consistent with the conclusion made by Qing who used the SAS score and 4 different kinds of questionnaires as the screening tools for OSAHS such that the excessive fat accumulation in the thorax due to obesity leads to a decline in chest wall compliance and an increase in respiratory muscle resistance, which are most apparent in a supine position, and hypoxemia occurs in severe cases, forming a vicious cycle (19).

In this study, HOMA-IR was the highest in the OSAHS + CHD group and the lowest in the OSAHS group (p < 0.05). According to the Spearman correlation analysis of AHI, LSaO₂, MSaO₂, CT90%, ODI, and MAI with HOMA-IR in both groups, AHI, CT90%, ODI, and MAI were positively correlated with HOMA-IR (r > 0), while LSaO₂ and MSaO₂ were negatively correlated with HOMA-IR (r < 0). Moreover, compared with the OSAHS group, the OSAHS + CHD group had obviously increased levels of serum inflammatory factors CRP, TNF-α, IL-6, and IFN-γ, displaying statistically significant differences (p < 0.05). Hotamisligil et al. studied and found that IR is closely related to plasma pro-inflammatory factors, and the enhanced IR corresponds to the increased secretion of pro-inflammatory cytokines. Due to the increase in respiratory resistance, the patient experiences hypoxia, and a large number of inflammatory cytokines are expressed, thereby increasing the concentration of inflammatory factors in plasma. Such a result is consistent with the conclusion made by Cai et al. in their study on respiratory resistance in OSAHS patients that there is an inseparable relationship between OSAHS and IR, heart disease, and inflammatory factors, which demonstrates that detection of IR, heart disease, and inflammatory factors in patients may have an important significance for the prevention and treatment of OSAHS (20).

In conclusion, glycolipid metabolism, obesity rate, HOMA-IR, and inflammatory factors are all significantly increased in OSAHS + CHD compared with OSAHS.

The original contributions presented in the study are included in the article/supplementary material. Further inquiries can be directed to the corresponding author.

The study was approved by the ethics committee of Beijing Luhe Hospital, and written informed consents were signed by the patients and/or guardians. The patients/participants provided their written informed consent to participate in this study.

YW wrote the manuscript. YW and HZ were responsible for questionnaire survey and measurement of somatology indexes. YT and RY performed ELISA. All authors contributed to the article and approved the submitted version.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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