Pływaczewski Robert, Bieleń Przemysław, Bednarek Michał, Jonczak Luiza, Górecka Dorota, Sliwiński Paweł
Zakład Diagnostyki i Leczenia Niewydolności Oddychania Instytutu Gruźlicy i Chorób Płuc w Warszawie Kierownik.
Pneumonol Alergol Pol. 2008;76(5):313-20.
Obesity and male gender are the main risk factors for the development of obstructive sleep apnoea (OSA); however, some epidemiological data has shown that neck circumference (NC) > or = 43 cm is a better predictor of obstructive event frequency than body mass index (BMI). The aim of this study was to assess the relation between NC and BMI on OSA severity in males.
The subjects completed a sleep questionnaire and Epworth sleepiness scale before the sleep study (full polysomnography or PolyMesam study). Authors studied 133 consecutive males with confirmed OSA (AHI/RDI > 10, Epworth score > 9 points). Chest X-ray, spirometry, arterial blood gases, ECG, blood morphology and biochemistry were performed during treatment trial with autoCPAP.
Subjects presented with obesity--BMI = 35.8 +/- 6.1 kg/m2, NC = 46 +/- 3.4 cm and severe disease--AHI/RDI = 45.3 +/- 23.6. Mean age was 52.7 +/- 11.3 years. The majority of subjects had NC > or = 43 cm (116 pts, 87.2% - group 1), 17 pts (12.8% - group 2) had NC < 43 cm had 17 pts. Comparison of both groups showed significant differences only for BMI (group 1 - 36.8 +/- 5.7, group 2 - 28.6 +/- 3.7; p < 0.0001). Linear regression analysis revealed significant correlation between NC and AHI/RDI (R2 = 0.07, r = 0.26; p = 0.003); however, the correlation between BMI and AHI/RDI was stronger (R2 = 0.14, r = 0.37; p < 0.0001). In multiple linear regression analysis we found significant correlation between AHI/RDI and age (beta = -0.31, p = 0.003) and BMI (beta = 0.34, p = 0.02).
The strongest correlation between AHI/RDI, younger age and BMI. Correlation between neck circumference and AHI/RDI was significant but less when compared to BMI.
肥胖和男性是阻塞性睡眠呼吸暂停(OSA)发生的主要危险因素;然而,一些流行病学数据表明,颈围(NC)≥43 cm比体重指数(BMI)更能预测阻塞性事件的发生频率。本研究的目的是评估男性中NC与BMI对OSA严重程度的关系。
受试者在睡眠研究(全夜多导睡眠图或PolyMesam研究)前完成一份睡眠问卷和爱泼华嗜睡量表。作者研究了133例确诊为OSA(呼吸暂停低通气指数/呼吸紊乱指数>10,爱泼华评分>9分)的连续男性患者。在使用自动持续气道正压通气(autoCPAP)治疗试验期间进行了胸部X光、肺功能测定、动脉血气分析、心电图、血液形态学和生物化学检查。
受试者存在肥胖——BMI=35.8±6.1kg/m²,NC=46±3.4cm,且患有严重疾病——呼吸暂停低通气指数/呼吸紊乱指数=45.3±23.6。平均年龄为52.7±11.3岁。大多数受试者的颈围≥43 cm(116例,87.2%——第1组),17例(12.8%——第2组)颈围<43 cm。两组比较仅在BMI方面存在显著差异(第1组——36.8±5.7,第2组——28.6±3.7;p<0.0001)。线性回归分析显示NC与呼吸暂停低通气指数/呼吸紊乱指数之间存在显著相关性(R²=0.07,r=0.26;p=0.003);然而,BMI与呼吸暂停低通气指数/呼吸紊乱指数之间的相关性更强(R²=0.14,r=0.37;p<0.0001)。在多元线性回归分析中,我们发现呼吸暂停低通气指数/呼吸紊乱指数与年龄(β=-0.31,p=0.003)和BMI(β=0.34,p=0.02)之间存在显著相关性。
呼吸暂停低通气指数/呼吸紊乱指数与年龄和BMI之间的相关性最强。颈围与呼吸暂停低通气指数/呼吸紊乱指数之间存在显著相关性,但与BMI相比程度较轻。