Kemppainen Tatu, Ruoppi Pirkko, Seppä Juha, Sahlman Johanna, Peltonen Markku, Tukiainen Hannu, Gylling Helena, Vanninen Esko, Tuomilehto Henri
Institute of Clinical Medicine, Otorhinolaryngology, Kuopio University Hospital, Kuopio, Finland.
Am J Rhinol. 2008 Jul-Aug;22(4):410-5. doi: 10.2500/ajr.2008.22.3203.
Elevated nasal resistance and obesity predispose to obstructive sleep apnea (OSA). Weight loss has been shown to result in an alleviation of OSA, but its effect on nasal airflow has not been studied.
This study was a prospective, randomized, controlled study with two parallel groups. A total of 52 adult overweight patients (body mass index [BMI], 28-40 kg/m2) with mild obstructive sleep apnea (apnea-hypopnea index (AHI), 5-15) were randomized into two study groups. The intervention group (n = 26) followed a very low calorie diet with a supervised lifestyle intervention while the control group (n = 26) received routine lifestyle counseling. The changes in BMI, total nasal resistance, total nasal volume, and quality of life scores (Mini Rhinoconjunctivitis Quality of Life Questionnaire, MiniRQLQ) were assessed at baseline and after the intervention at 3 months.
The reduction in BMI in the intervention group was significantly greater than that achieved by patients in the control group (5.4 kg/m2 versus 0.5 kg/m2). Accordingly, AHI was reduced by 3.2 events/hour in the intervention group and by 1.3 in the control group. However, there were no significant changes in rhinometric measurements despite significant weight loss. There was no correlation between the reduction of BMI and the change in nasal resistance or MiniRQLQ scores.
Weight reduction does not seem to have any effect on nasal resistance or volume in overweight patients with mild OSA. Patients with OSA and impaired nasal breathing need specific medical or surgical treatment to restore nasal airflow.
鼻阻力升高和肥胖易导致阻塞性睡眠呼吸暂停（OSA）。已表明体重减轻可减轻OSA，但尚未研究其对鼻气流的影响。
本研究为前瞻性、随机、对照研究，分为两个平行组。共有52名成年超重患者（体重指数[BMI]，28 - 40 kg/m²）患有轻度阻塞性睡眠呼吸暂停（呼吸暂停低通气指数（AHI），5 - 15），被随机分为两个研究组。干预组（n = 26）采用极低热量饮食并接受监督的生活方式干预，而对照组（n = 26）接受常规生活方式咨询。在基线时以及干预3个月后评估BMI、总鼻阻力、总鼻容积和生活质量评分（迷你鼻结膜炎生活质量问卷，MiniRQLQ）的变化。
干预组BMI的降低显著大于对照组患者（5.4 kg/m²对0.5 kg/m²）。相应地，干预组AHI每小时降低3.2次事件，对照组降低1.3次。然而，尽管体重显著减轻，但鼻测量值并无显著变化。BMI的降低与鼻阻力或MiniRQLQ评分的变化之间无相关性。
体重减轻似乎对轻度OSA超重患者的鼻阻力或容积没有任何影响。患有OSA且鼻呼吸受损的患者需要特定的药物或手术治疗来恢复鼻气流。
