心外膜脂肪组织厚度和复合炎症指标在阻塞性睡眠呼吸暂停综合征患者中的临床意义OA

Objective To to investigate the association between inflammatory markers and epicar-dial adipose tissue(EAT)thickness in patients with obstructive sleep apnoea-hypopnoea syndrome(OSAHS).Methods A total of 247 patients who underwent sleep respiratory monitoring at the Affili-ated Hospital of Yangzhou University from January 2022 to December 2025 were enrolled.Patients were classified into non-OSAHS group(apnoea-hypopnoea index[AHI]＜5 events/h,n=50)and OSAHS group(AHI ≥5 events/h,n=197)according to AHI.The OSAHS group was further stratified into mild OSAHS subgroup(n=73)and moderate-to-severe OSAHS subgroup(n=124).Fasting venous blood samples were collected within 24 h of admission for clinical indicator assessment.Results The OSAHS group exhibited a higher proportion of male patients,greater body mass index(BMI),and higher creatinine(Cr)levels than the non-OSAHS group,whereas lymphocyte count(LY)was lower(P＜0.05).The OSAHS group showed significantly elevated systemic immune-in-flammation index(SII),systemic inflammation response index(SIRI),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),neutrophil-to-monocyte and lymphocyte-ratio(NMLR),C-reactive protein-to-lymphocyte ratio(CLR),inflammatory burden index(IBI),and aggregate index of systemic inflammation(AISI)compared with the non-OSAHS group(P＜0.05).EAT thickness at the left ventricular apical region and the left coronary artery in the atrioventricular groove was significantly greater in the OSAHS group than in the non-OSAHS group(P＜0.05).Bi-nary univariable logistic regression identified sex,LY,BMI,Cr,SII,NLR,PLR,NMLR,and EAT thickness at both the left coronary artery in the atrioventricular groove and the left ventricular apical region as factors associated with OSAHS.Binary multivariable logistic regression revealed that EAT thickness at the left ventricular apical region was an independent predictor of OSAHS(OR=2.888;95％CI,1.918 to 4.348;P＜0.05).EAT thickness at the left ventricular apical region was negatively correlated with female sex and LY,and positively correlated with BMI,Cr,SII,NLR,PLR,and NMLR(P＜0.05).The area under the receiver operating characteristic curve(AUC)for EAT thickness at the left ventricular apical region in predicting OSAHS was 0.881(95％CI,0.838 to 0.924),with an optimal cut-off value of 5.550 mm,yielding a sensitivity of 71.6％and a specificity of 92.0％.The moderate-to-severe OSAHS subgroup showed higher mono-cyte-to-lymphocyte ratio(MLR)levels and greater EAT thickness at both the left ventricular apical region and the left coronary artery in the atrioventricular groove than the mild OSAHS subgroup(P＜0.05).Binary multivariable logistic regression identified BMI and EAT thickness at both the left coronary artery in the atrioventricular groove and the left ventricular apical region as independent predictors of moderate-to-severe OSAHS(P＜0.05).The combined AUC of these indicators for predicting moderate-to-severe OSAHS was 0.977(95％CI,0.960 to 0.995),with a sensitivity of 97.6％and a specificity of 87.8％.Conclusion EAT thickness at the left ventricular apical region is significantly increased in patients with OSAHS and is strongly associated with disease severity.Pa-tients with moderate-to-severe OSAHS exhibit further increases in EAT thickness at both the left ven-tricular apical region and the left coronary artery in the atrioventricular groove.