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A Pilot Study of Heart Rate Variability and Apneic-hypopneic Events in Non-Obese Women with Polycystic Ovary Syndrome during Sleep
非肥胖且未治療之多囊性卵巢症候群患者其心率變異性與窒息低息指數表現相關性之初探
摘要
多囊性卵巢症候群患者相較於對照組，具有較高之窒息低息指數，然而其睡眠當中窒息低息的狀況與其心率變異性之關係則尚待研究。本研究受試者包括研究組14個實驗組思者與對照組11人（身體質量指數各為21.51±0.63與21.27±0.66)，接受整晚之睡眠多項生理檢查，並評估胰島素抗性。心率部份經頻譜分析檢視不同睡眠階段的短期心率變異性，及6小時長期心率變異性。結果見實驗組之窒息低息指數與覺醒指數，於非快速動眼期時比對照組高(0.032±0.028vs.0.698±0.243p=0.004; 11.45±0.864vs.8.636±0.847p=0.0484)。而實驗組之長期心率變異性中，心跳間隔的三角底寬較低(303.9±19.23vs355.9±10.97p=0.0484)。於校正年齡、體脂肪百分比、血清男性荷爾蒙後，其與窒息低息指數為負相關，亦與高敏感C反應蛋白為負相關；快速動眼期之窒息低息指數則與高敏感C反應蛋白正相關。即使在患者未肥胖時，多囊性卵巢症候群具有較差之心臟交感神經功能，從而影響其睡眠當中的心率變異性。
並列摘要
Background: Patients with polycystic ovary syndrome (PCOS) have a higher apnea-hypopnea index (AHI) than did controls. The relationship between heart rate variability (HRV) changes and apneic-hypopneic events in non-obese women with PCOS during sleep is yet to be determined. Methods: All participants (14 untreated women with PCOS and 11 age-and BMI-controlled healthy women, with mean body mass indexes of 21.51±0.63 and 21.27±0.66 Kg/cm^2, respectively) underwent whole-night standard polysomnographic (PSG) monitoring and assessment of serum hormone and homeostasis model assessment of insulin resistance (HOMA-IR). Short-term HRV (in different sleep stages) and long-term HRV (6-hour sleep) were obtained by a power spectral analys is. Results: The AHI and arousal index during the non-rapid eye movement stage (AHI(subscript NREM) and ARI(subscript NREM) were both higher in non-obese women with PCOS than those in the control group (0.032±0.028 vs. 0.698±0.243 p=0.004; 11.45±0.864 vs. 8.636±0.847 p=0.045 Triangular interpolation of the NN interval histogram TINN) of long-term HRV in the PCOS group was also lower (303.9±19.23 vs. 355.9±10.97, p=0.0484) .TINN in all subjects was negatively correlated to the AHI, after adjusting for age, body fat percentage, and serum androgens. TINN had negative relation with highly sensitive C-reactive protein (hsCRP) while AHIREM was positively related to hsCRP. Conclusions: Non-obese patients with PCOS showed poorer long-term TINN during sleep compared to the controls. The TINN was related to AHI and hsCRP. PCOS patients suffered from worsened cardiac nerve autonomous function that could lead to long-term cardiovascular risk during sleep even when they are not obese.