| Abstract: | 排除睡眠呼吸障礙的干擾，性別仍明顯影響血漿中三酸甘油、尿酸及血壓。研究目標：睡眠呼吸，好發於男性，明顯與全身發炎、高血壓及代謝功能障礙密切相關。經由性荷爾蒙的保護，女性有較優的代謝狀態及心血管功能，這可能歸因於睡眠時有較佳的上呼吸通暢度及穩定的中樞呼吸調控機制，本研究旨在驗證，在排除睡眠呼吸障礙，女性仍存在上述優勢。研究設計：逆向分析對比研究。結論：在睡眠呼吸障礙的考量下，女性在三酸甘油、尿酸、血漿濃度與血壓各值均較男性為低，而這優勢在遇停經年齡後，不復存在，可能是內臟脂肪變動所影響。
Study Objectives: Sleep-disordered-breathing, more male-prevalent, is associated with systemic inflammation, hypertension and metabolic aberration. Through sexual hormones’’ protections, female have metabolic and cardiovascular preferences, speculatively attributed to better upper-airway conductivity and central-breathing control during sleep. The aim of this study is to investigate if above female superiorities exist when adjusted for sleep-disordered-breathing severity.Design: Retrospective data review analysis.Participants: 84 randomly-selected eligible sleep-disturbance female patients were enrolled to be matched with a male individually for apnea-hypopnea index (AHImt) or not (nAHImt), besides for age (< and and 50 years [the average menopausal age, Taiwan]; Junior and Senior) and body mass index. Measurements and Results: In Junior/nAHImt (51 pairs), female (35.78.3 vs. 35.58.1 years, female vs. male; in same sequences as follows) had shorter neck circumference, better sleep architecture, lower AHI (16.217.5 vs. 30.324.3 events/hr), Epworth Sleepiness Scale score (ESS), blood pressure (BP), serial levels of total cholesterol (TC), triglyceride (TG) (9751 vs. 147142 mg/dL) and uric acid (UA) (5.11.4 vs. 6.31.5 mg/dL). In Junior/AHImt (33 pairs), female (38.67.9 vs. 38.98.5 years) appeared shorter neck circumference, lower waist/hip ratio (0.850.07 vs. 0.910.06), ESS, BP, TG(9643 vs.142115 mg/dL) and UA (4.71.4 vs. 6.41.62 mg/dL). While in Senior/nAHImt (51 pairs), female (56.35.1 vs. 56.55.7 years) had lower AHI, neck circumference, and waist/hip ratio, with lower diastolic BP and UA (5.42.0 vs. 6.41.7 mg/dL). In Senior/AHImt (33 pairs), female (56.95.1 vs. 57.55.8 years) had similar waist/hip ratio, sleep architecture, BP, the lipid profile values, C-reaction protein, and UA. UA positively correlated with TG in Junior/male and Senior/female. In two triple-matched groups, positive correlations were found in UA-systolic BP and UA-TG of both Junior/male and Senior/female; and waist/hip ratio-UA of Junior and Senior/female. Conclusions: Beyond sleep-disordered-breathing’’s attenuating effect, female’’s gender preferences on TG, UA and BP persist till menopause age, potentially through central fat evolution. |
