在肥胖症手术的纵向评估-2（LABS-2）研究中对接受减重手术的成年人进行阻塞性睡眠呼吸暂停评估。
Assessment of obstructive sleep apnea in adults undergoing bariatric surgery in the longitudinal assessment of bariatric surgery-2 (LABS-2) study.
机构信息
Oregon Health and Science University, Portland, OR 97239-3098, USA.
出版信息
J Clin Sleep Med. 2013 Jan 15;9(1):21-9. doi: 10.5664/jcsm.2332.
STUDY OBJECTIVES
Evaluate frequency of diagnostic testing for obstructive sleep apnea (OSA), prevalence of OSA, and factors independently associated with OSA status in adults undergoing bariatric surgery. DESIGN, SETTINGS AND INTERVENTIONS: Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) is an observational cohort of 2,458 adults undergoing bariatric surgery at 10 U.S. hospitals. Within 30 days prior to surgery, researchers determined if participants had a diagnostic polysomnography (PSG) in the previous 12 months. When available, apnea-hypopnea index (AHI) was recorded. Based on medical records and participant report, research clinicians recorded OSA status and positive airway pressure (PAP) use. Participants completed the Berlin Questionnaire (BQ). Multivariable logistic regression was used to determine factors independently associated with AHI-confirmed OSA status.
RESULTS
28.7% (n = 693) of participants had a PSG within 12 months before surgery. Of subjects with AHI available (n = 509), 80.7% (n = 411) had OSA (AHI ≥ 5); 83.0% (n = 341) reported PAP use. In participants without a known AHI (n = 1,949), 45.4% (n = 884) had self-reported OSA; 81.2% (n = 718) reported PAP use. Self-reported history of snoring and pauses in breathing (odds ratio [OR] = 10.0; 95%, confidence interval [CI] = 4.8-20.6), male sex (OR = 5.1; 95% CI = 1.7-15.3), older age (OR = 1.4; 95% CI = 1.2-1.6 per 5 years), and larger sagittal abdominal diameter (OR = 1.8; 95% CI = 1.2-2.5 per 5 cm) were independently associated with a greater odds of confirmed OSA.
CONCLUSIONS
Preoperative diagnostic testing for OSA was infrequent. Prevalence estimates of OSA differed greatly between those with and without a past-year AHI (81% vs. 46%, respectively). Most BQ responses did not differentiate OSA status, but endorsement of snoring and pauses in breathing was independently associated with presence of OSA.
研究目的
评估肥胖症患者阻塞性睡眠呼吸暂停（OSA）的诊断检测频率、OSA 的患病率以及与 OSA 状态相关的独立因素。
设计、地点和干预措施：肥胖症手术的纵向评估-2（LABS-2）是一项观察性队列研究，共纳入了在美国 10 家医院接受减肥手术的 2458 名成年人。在手术前 30 天内，研究人员确定参与者在过去 12 个月内是否进行过诊断性多导睡眠图（PSG）检查。当 PSG 可用时，记录呼吸暂停低通气指数（AHI）。根据医疗记录和参与者报告，研究临床医生记录了 OSA 状态和使用正压通气（PAP）的情况。参与者完成了柏林问卷（BQ）。多变量逻辑回归用于确定与 AHI 确认的 OSA 状态相关的独立因素。
结果
28.7%（n=693）的参与者在手术前 12 个月内进行了 PSG 检查。在有 AHI 可用的受试者中（n=509），80.7%（n=411）有 OSA（AHI≥5）；83.0%（n=341）报告使用 PAP。在没有已知 AHI 的参与者中（n=1949），45.4%（n=884）自述有 OSA；81.2%（n=718）报告使用 PAP。自述有打鼾和呼吸暂停史（比值比[OR] = 10.0；95%置信区间[CI] = 4.8-20.6）、男性（OR = 5.1；95%CI = 1.7-15.3）、年龄较大（OR = 1.4；95%CI = 1.2-1.6 每 5 年）和更大的矢状腹部直径（OR = 1.8；95%CI = 1.2-2.5 每 5 厘米）与 OSA 确诊几率增加独立相关。
结论
术前 OSA 的诊断检测频率较低。过去一年有 AHI 和没有 AHI 的 OSA 患病率差异很大（分别为 81%和 46%）。大多数 BQ 回答并不能区分 OSA 状态，但打鼾和呼吸暂停的出现与 OSA 的存在独立相关。
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