Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
Obesity (Silver Spring). 2013 Apr;21(4):847-51. doi: 10.1002/oby.20288.
Epidemiologic studies that control for potential confounders are needed to assess the independent associations of obstructive sleep apnea (OSA) with metabolic abnormalities. The aim of our study was to evaluate the associations of OSA with metabolic abnormalities among the adult population of Sao Paulo, Brazil.
Questionnaires were applied face-to-face, full night polysomnography (PSG) was performed, and blood samples were collected in a population-based survey in Sao Paulo, Brazil, adopting a probabilistic three-stage cluster sample method. The metabolic profile included fasting glucose, insulin, and lipid levels. The hepatic insulin resistance index was assessed by the homeostasis model assessment-estimated insulin resistance (HOMAIR ).
A total of 1,042 volunteers underwent PSG. Mild OSA and moderate to severe OSA comprised 21.2% and 16.7% of the population, respectively. Subjects with severe to moderate OSA were older, more obese, had higher fasting glucose, HOMAIR , and triglycerides (TG) levels than did the mild and non-OSA group (P < 0.001). Multivariate regression analyses showed that an apnea-hypopnea index (AHI) ≥ 15 and a time of oxy-hemoglobin saturation <90% were independently associated with impaired fasting glucose, elevated TG, and HOMAIR .
The results of this large cross-sectional epidemiological study showed that the associations of OSA and metabolic abnormalities were independent of other risk factors.
需要进行控制潜在混杂因素的流行病学研究，以评估阻塞性睡眠呼吸暂停（OSA）与代谢异常之间的独立关联。我们研究的目的是评估巴西圣保罗成年人中 OSA 与代谢异常之间的关联。
在巴西圣保罗采用概率三阶段聚类抽样方法，进行了一项基于人群的调查，面对面应用问卷，进行整夜多导睡眠图（PSG）检查，并采集血液样本。代谢特征包括空腹血糖、胰岛素和血脂水平。通过稳态模型评估-估计胰岛素抵抗（HOMAIR）评估肝胰岛素抵抗指数。
共有 1042 名志愿者接受了 PSG 检查。轻度 OSA 和中重度 OSA 分别占人群的 21.2%和 16.7%。与轻度和非 OSA 组相比，中重度 OSA 组的年龄更大、更肥胖，空腹血糖、HOMAIR 和甘油三酯（TG）水平更高（P<0.001）。多变量回归分析显示，呼吸暂停低通气指数（AHI）≥15 和血氧饱和度<90%的时间与空腹血糖受损、TG 升高和 HOMAIR 升高独立相关。
这项大型横断面流行病学研究的结果表明，OSA 和代谢异常之间的关联独立于其他危险因素。
