Lettieri Christopher J, Eliasson Am H, Andrada Teotimo, Khramtsov Andrei, Raphaelson Marc, Kristo David A
Pulmonary, Critical Care and Sleep Medicine Service, Walter Reed Army Medical Center, Washington, DC 20307, USA.
J Clin Sleep Med. 2005 Oct 15;1(4):381-5.
While age and body-mass index (BMI) are well-established risk factors for obstructive sleep apnea syndrome (OSAS), this disorder occurs across a wide spectrum of ages and weights. Preconceptions regarding "classic" patients with OSAS may lead to underdiagnosis in at-risk populations, particularly younger nonoverweight individuals. We hypothesized that the severity of OSAS is independent of age and BMI in a younger less-obese population.
Prospective study of consecutive patients diagnosed with OSAS. Active-duty military, National Guardsmen, and civilians were compared to determine if age and BMI correlated with disease severity.
Two hundred seventy subjects (120 active-duty, 80 National Guardsmen, 70 civilians) were included. Active-duty military members were significantly younger and less overweight than both National Guardsmen and civilians. Of the civilians, 64.3% and, of National Guardsmen, 48.8% were obese, whereas only 19.2% of active-duty had a BMI > or = 30 kg/m2 (p < .001). However, the prevalence of severe disease did not differ between groups. Disease severity showed no correlation with BMI among active-duty subjects (r = 0.09, p = .33). Of the active-duty subjects, 37.5% had severe disease, as compared with 42.5% of National Guard and 45.7% of civilian subjects (p = .18 and .09, respectively). BMI did not differ between active-duty subjects with severe disease and those with mild to moderate OSAS (26.7 kg/m2 versus 26.9 kg/m2, p = .40). There was a low but significant correlation between age and AHI (r = 0.21, p = .02) among all subjects.
OSAS occurs in young nonobese individuals and should be considered in patients reporting excessive daytime sleepiness, regardless of age or BMI.
虽然年龄和体重指数（BMI）是阻塞性睡眠呼吸暂停综合征（OSAS）公认的危险因素，但这种疾病在广泛的年龄和体重范围内都会出现。对OSAS“典型”患者的先入之见可能导致高危人群的漏诊，尤其是年轻的非超重个体。我们假设在年轻、肥胖程度较低的人群中，OSAS的严重程度与年龄和BMI无关。
对连续诊断为OSAS的患者进行前瞻性研究。比较现役军人、国民警卫队队员和平民，以确定年龄和BMI是否与疾病严重程度相关。
纳入了270名受试者（120名现役军人、80名国民警卫队队员、70名平民）。现役军人比国民警卫队队员和平民都明显更年轻且超重程度更低。平民中64.3%、国民警卫队队员中48.8%为肥胖，而现役军人中只有19.2%的BMI≥30kg/m²（p<0.001）。然而，各组间严重疾病的患病率并无差异。现役受试者中疾病严重程度与BMI无相关性（r=0.09，p=0.33）。现役受试者中37.5%患有严重疾病，相比之下，国民警卫队队员为42.5%，平民为45.7%（p分别为0.18和0.09）。患有严重疾病的现役受试者与患有轻度至中度OSAS的受试者之间的BMI无差异（26.7kg/m²对26.9kg/m²，p=0.40）。在所有受试者中，年龄与呼吸暂停低通气指数（AHI）之间存在低但显著的相关性（r=0.21，p=0.02）。
OSAS发生在年轻的非肥胖个体中，对于报告白天过度嗜睡的患者，无论其年龄或BMI如何，都应考虑该疾病。
