Role of bronchial hyperresponsiveness in patients with obstructive sleep apnea with asthma-like symptoms

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  • Sano Akiko
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Kozuka Takenori
    Department of Radiology, Kindai University Faculty of Medicine
  • Watatani Nanase
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Kunita Yuuki
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Kawabata Yoshiyuki
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Gose Kyuya
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Shirahase Ken
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Yoshikawa Kazuya
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Yamazaki Ryo
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Nishikawa Yusaku
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Omori Takashi
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Nishiyama Osamu
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Iwanaga Takashi
    Center for General Medical Education and Clinical Training, Kindai University Hospital
  • Sano Hiroyuki
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Haraguchi Ryuta
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Tohda Yuji
    Kindai University Hospital
  • Matsumoto Hisako
    Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine

抄録

<p>Background: Obstructive sleep apnea (OSA) is one of the major co-morbidities and aggravating factors of asthma. In OSA-complicated asthma, obesity, visceral fat, and systemic inflammation are associated with its severity, but the role of bronchial hyperresponsiveness (BHR) is unclear. We investigated the involvement of BHR and mediastinal fat width, as a measure of visceral fat, with OSA severity in patients with OSA and asthma-like symptoms.</p><p>Methods: Patients with OSA who underwent BHR test and chest computed tomography scan for asthma-like symptoms were retrospectively enrolled. We evaluated the relationship between apnea-hypopnea index (AHI) and PC20 or anterior mediastinal fat width, stratified by the presence or absence of BHR.</p><p>Results: OSA patients with BHR (n = 29) showed more obstructive airways and frequent low arousal threshold and lower mediastinal fat width, and tended to show fewer AHI than those without BHR (n = 25). In the overall analysis, mediastinal fat width was significantly positively correlated with AHI, which was significant even after adjustment with age and gender. This was especially significant in patients without BHR, while in OSA patients with BHR, there were significant negative associations between apnea index and airflow limitation, and hypopnea index and PC20.</p><p>Conclusions: Risk factors for greater AHI differed depending on the presence or absence of BHR in OSA patients with asthma-like symptoms. In the presence of BHR, severity of asthma may determine the severity of concomitant OSA.</p>

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