Li Nan-fang, Zhang Li-li, Yan Zhi-tao, Han Rui-mei, Cheng Wei-ping
Hypertension Institute of Xinjiang, Urumuqi, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Feb;40(2):120-4.
To investigate the impact of obesity on incidence of obstructive sleep apnea-hypopnea syndrome (OSAHS) in hospitalized hypertensive patients.
A total of 825 hospitalized hypertensive patients from April 1 to June 30 in 2009 in our hospital were included. Patients were asked to answer the questions concerning snoring, daytime sleepiness. Patients with loud snoring and daytime sleepiness, tubbiness neck, retrognathia, enlarged tongue, orolingual cyanosis were selected to undergo polysomnography monitoring for a whole night. OSAHS is defined by clinical symptoms and apnea-hypopnea index (AHI) not less than 5 per hour.
(1) The detection rate of OSAHS in this cohort was 23.52% (178/825), 34.34% (148/431) in males and 11.68% (46/394) in females respectively. (2) The detection rate was 6.6% (12/183) in normal weight subjects, 22.22% (78/351) in overweight subjects and 36.75% (104/283) in obesity subjects (χ(2) = 56.736, P < 0.01). The severe OSAHS rate in obesity group (16.61%) was significantly higher than that in normal weight group (2.19%) and overweight group (7.69%, χ(2) = 29.219, P < 0.01). (3) The OSAHS rate was 7.83% (9/115) in normal waist circumference group and 26.29% (184/700) in centricity obesity group (χ(2) = 18.623, P < 0.01). The severe OSAHS rate was 2.61% (3/115) in normal waist circumference group and 10.57% (74/700) in centricity obesity (χ(2) = 7.32, P < 0.01). (4) The moderate to severe OSAHS rate increased in proportion with BMI increase in female patients (χ(2) = 5.846, P < 0.05) and increased in proportion with BMI and waist circumference increase in male patients (P < 0.01).
The incidence of OSAHS in hypertensive patients is high. Obesity further increases the morbidity of OSAHS in hypertensive patients.
探讨肥胖对住院高血压患者阻塞性睡眠呼吸暂停低通气综合征（OSAHS）发病率的影响。
纳入我院2009年4月1日至6月30日期间住院的825例高血压患者。询问患者有关打鼾、日间嗜睡的问题。选择有大声打鼾、日间嗜睡、颈部肥胖、下颌后缩、舌体增大、口周发绀的患者进行整夜多导睡眠图监测。OSAHS根据临床症状及呼吸暂停低通气指数（AHI）每小时不少于5次来定义。
（1）该队列中OSAHS的检出率为23.52%（178/825），男性为34.34%（148/431），女性为11.68%（46/394）。（2）正常体重者的检出率为6.6%（12/183），超重者为22.22%（78/351），肥胖者为36.75%（104/283）（χ² = 56.736，P < 0.01）。肥胖组的重度OSAHS发生率（16.61%）显著高于正常体重组（2.19%）和超重组（7.69%，χ² = 29.219，P < 0.01）。（3）正常腰围组的OSAHS发生率为7.83%（9/115），中心性肥胖组为26.29%（184/700）（χ² = 18.623，P < 0.01）。正常腰围组的重度OSAHS发生率为2.61%（3/115），中心性肥胖组为10.57%（74/700）（χ² = 7.32，P < 0.01）。（4）女性患者中，中重度OSAHS发生率随BMI增加而升高（χ² = 5.846，P < 0.05），男性患者中，中重度OSAHS发生率随BMI及腰围增加而升高（P < 0.01）。
高血压患者中OSAHS的发病率较高。肥胖进一步增加了高血压患者中OSAHS的发病风险。
