The frequency and outcomes of syndrome 'z' in patients with osas

Aim: To determine the prevalence of Metabolic Syndrome, Sleep apnea and Sydnrome Z in patients presenting to the sleep clinic of Dicle Üniversity school of Medicine. İn addition to that, the relationship between sleep apnea and central obesity, hypertension, impaired fasting glucose-DM, high blood triglyceride level and low HDL-C was planned to investigate in this study. Material and Method: This was a prospective study. All Patients who were admitted into sleep clinic of our hospital between 10.31.2018 to 02.13.2019 and accepted to participate were included in the study. A detailed history was taken from our patients who would be subject to polysomnography test on the day of the procedure. The resting blood pressures were measured two times in mm-Hg with 5-minute intervals from the patients, and the arithmetic mean of these systolic and diastolic blood pressures were taken as basis. On the day of the procedure, the weight of the patients was measured in kilograms on a thin dress. The waist circumference and the neck circumference of the patients were measured in centimeters. Fasting serum glucose, and lipid panel were measured from all patients after the procedure. The criterias of National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP III) were used for diagnosis of Methabolic syndrome. According to the results of polsomnography test, Patients were grouped into four different categoires as per Apnea-Hypopnea Index (AHI) which were simple snoring (AHI<5/h), Mild Sleep Apnea (AHİ;5-15/h), Moderate Sleep Apnea (AHİ:15-30/h) and Severe Sleep Apnea (AHİ>30/h) respectively. SPSS 22 program was used to calculate the statistical data. Statistical significance was accepted as p <0.05. Results: 142 (94 Male) patients were included into the study. Age, weight, BMİ and waist circumference were associated with an increase in risk of OSAS. 79/142 patients met the syndrome Z criterias and the frequency of the syndrome Z was found to be 55.6% among all patients. The rate of Syndrome Z was 59.8% in OSAS patients and 96.3% in patients with Metabolic Syndrome. The prevelance of Methabolic syndrome and OSAS were 57,7% (n=82) and 93% (n=132) respectively. Central obesity was present in 100 patients while hypertension in 74 patients, impaired fasting glucose-DM in 45 patients, high blood triglyceride levels in 82 patients and low HDL-C levels in 83 patients. Of all patients, 10 patients had simple snoring, 21 had Mild sleep apnea, 32 had Moderate sleep apnea and 79 had Severe sleep apnea. Central obesity, hypertension and impaired glucose metabolism-DM risk were increased in patients with sleep apnea and this differences were statistically significant (p< 0.05). İn regards of hypertention, especially diastolic blood pressures were higher in patients with OSAS. No significant relationship was found between sleep apnea and high triglyceride levels or low HDL-C levels (p > 0.05). Metabolic parameters also were not found to be associated with AHI in the study. Finally, There was no significant relationship between GAUH and sleep apnea or Metabolic Syndrome parameters. Conclusion : İt has been shown that there is increased hypertension, obesity and DM rates in patients with OSAS in this study. Given very high rates of OSAS in patients with Metabolic Syndrome (96.3%) reinforce the relationship between OSAS and Metabolic Syndrome. It is important to know the relationship between OSAS and metabolic syndrome because of the increased risk of cardiovascular and cerebrovascular diseases in both situation. The lipid panel within the criterias on metabolic syndrome was not found to be associated with OSAS and AHI which was probably due to significant low number of OSAS negative patients in our study. New studies with larger patient numbers may show more clearly this relationship in the future