Brown Mark A, Goodwin James L, Silva Graciela E, Behari Ajay, Newman Anne B, Punjabi Naresh M, Resnick Helaine E, Robbins John A, Quan Stuart F
Department of Psychiatry, Kaiser Permanente, Portland, OR (
Southwest J Pulm Crit Care. 2011 Dec 8;3:159-168.
It is well known that obesity is a risk factor for sleep-disordered breathing (SDB). However, whether SDB predicts increase in BMI is not well defined. Data from the Sleep Heart Health Study (SHHS) were analyzed to determine whether SDB predicts longitudinal increase in BMI, adjusted for confounding factors. METHODS: A full-montage unattended home polysomnogram (PSG) and body anthropometric measurements were obtained approximately five years apart in 3001 participants. Apnea-hypopnea index (AHI) was categorized using clinical thresholds: < 5 (normal), ≥ 5 to <15 (mild sleep apnea), and ≥ 15 (moderate to severe sleep apnea). Linear regression was used to examine the association between the three AHI groups and increased BMI. The model included age, gender, race, baseline BMI, and change in AHI as covariates. RESULTS: Mean (SD) age was 62.2 years (10.14), 55.2% were female and 76.1% were Caucasian. Five-year increase in BMI was modest with a mean (SD) change of 0.53 (2.62) kg/m(2) (p=0.071). A multivariate regression model showed that subjects with a baseline AHI between 5-15 had a mean increase in BMI of 0.22 kg/m(2) (p=0.055) and those with baseline AHI ≥ 15 had a BMI increase of 0.51 kg/m(2) (p<0.001) compared to those with baseline AHI of <5. CONCLUSION: Our findings suggest that there is a positive association between severity of SDB and subsequent increased BMI over approximately 5 years. This observation may help explain why persons with SDB have difficulty losing weight.
众所周知，肥胖是睡眠呼吸紊乱（SDB）的一个风险因素。然而，SDB是否能预测体重指数（BMI）的增加尚不清楚。对睡眠心脏健康研究（SHHS）的数据进行分析，以确定SDB是否能预测经混杂因素校正后的BMI纵向增加。方法：在3001名参与者中，大约相隔五年进行了一次全导联无人值守家庭多导睡眠图（PSG）检查和身体人体测量。使用临床阈值对呼吸暂停低通气指数（AHI）进行分类：<5（正常）、≥5至<15（轻度睡眠呼吸暂停）和≥15（中度至重度睡眠呼吸暂停）。采用线性回归分析三组AHI与BMI增加之间的关联。该模型将年龄、性别、种族、基线BMI和AHI变化作为协变量。结果：平均（标准差）年龄为62.2岁（10.14），55.2%为女性，76.1%为白种人。BMI的五年增幅较小，平均（标准差）变化为0.53（2.62）kg/m²（p=0.071）。多变量回归模型显示，与基线AHI<5的受试者相比，基线AHI在5-15之间的受试者BMI平均增加0.22 kg/m²（p=0.055），基线AHI≥15的受试者BMI增加0.51 kg/m²（p<0.001）。结论：我们的研究结果表明，SDB的严重程度与大约5年内随后BMI的增加之间存在正相关。这一观察结果可能有助于解释为什么患有SDB的人难以减肥。
