Ting Hua, Liou Cher-Ming, Shih Tung-Sheng, Wang Chih-Huan, Chang Shu-Yun, Chung Ai-Hui, Lee Jia-Fei, Wang Lee, Huang Ren-Jing, Lee Shin-Da
Department of Physical Medicine and Rehabilitation, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan.
Center of Sleep Medicine, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan.
Sleep Breath. 2015 Dec;19(4):1167-74. doi: 10.1007/s11325-015-1132-z. Epub 2015 Feb 10.
Both proteinuria and obstructive sleep apnea (OSA) are associated with cardiovascular events and consequent mortality. To examine whether age, OSA, diabetes, and obesity are potential predictors of proteinuria, a data-driven analysis was performed to delineate a potential categorical classification algorithm.
In this cross-sectional community-based cohort study, demographic data, blood pressure, serum biochemical analyses, proteinuria via single dipstick urinalysis, and overnight polysomnographies were measured in 300 males with sedentary work styles.
Sixty-one (20.3 %) of all these participants had proteinuria. Logistic regression analysis showed that glycated hemoglobin (HbA1c), duration of arterial oxygen saturation <90 %, age, and log high-sensitivity C-reactive protein, but not apnea-hypopnea index (AHI), were responsible for 16.7 % of the variance of proteinuria's presence. A decision tree analysis showed that subjects over 49 years old had a higher risk for proteinuria than those subjects of 49 years old, or less. In the over 49-year-old group, subjects with an AHI >21 events/h had a higher risk for proteinuria; whereas in the 49-year-old and less group, subjects with HbA1c >7 %, or with HbA1c ≤7, and body mass index (BMI) >27.4 kg/m(2) had a higher risk for proteinuria than their counterparts.
AHI was the major determinant responsible for the presence of proteinuria in late mid-aged male workers, while HbA1c and BMI were found in the junior subgroup. By algorithmic analysis, this study provides a comprehensive hierarchical model for better understanding of the correlates of proteinuria and sleep apnea.
蛋白尿和阻塞性睡眠呼吸暂停（OSA）均与心血管事件及随后的死亡率相关。为了研究年龄、OSA、糖尿病和肥胖是否为蛋白尿的潜在预测因素，我们进行了一项数据驱动分析，以描绘一种潜在的分类算法。
在这项基于社区的横断面队列研究中，对300名从事久坐工作的男性测量了人口统计学数据、血压、血清生化分析、单次尿试纸条法检测的蛋白尿以及夜间多导睡眠图。
所有这些参与者中有61人（20.3%）存在蛋白尿。逻辑回归分析显示，糖化血红蛋白（HbA1c）、动脉血氧饱和度<90%的持续时间、年龄和高敏C反应蛋白对数，但不是呼吸暂停低通气指数（AHI），可解释蛋白尿存在差异的16.7%。决策树分析显示，49岁以上的受试者蛋白尿风险高于49岁及以下的受试者。在49岁以上组中，AHI>21次/小时的受试者蛋白尿风险更高；而在49岁及以下组中，HbA1c>7%，或HbA1c≤7且体重指数（BMI）>27.4kg/m²的受试者蛋白尿风险高于其对应者。
AHI是中年晚期男性工作者蛋白尿存在的主要决定因素，而HbA1c和BMI则在年轻亚组中被发现。通过算法分析，本研究提供了一个综合的分层模型，以更好地理解蛋白尿与睡眠呼吸暂停的相关性。
