Yeh Nai-Cheng, Tien Kai-Jen, Yang Chun-Ming, Wang Jhi-Joung, Weng Shih-Feng
From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center (N-CY, K-JT); Department of Neurology (C-MY); Department of Medical Research, Chi Mei Medical Center (J-JW); Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan (S-FW); and Department of Senior Citizen Service Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan (K-JT).
Medicine (Baltimore). 2016 Jan;95(2):e2293. doi: 10.1097/MD.0000000000002293.
Obstructive sleep apnea (OSA), characterized by repetitive episodes of apnea/hypopnea and hypoxia, is associated with systemic inflammation and induces metabolic, endocrine, and cardiovascular diseases. Inflammation might have an impact on neurodegenerative diseases. This study investigates the possible association between OSA and Parkinson's disease (PD). Random samples out of 1 million individuals were collected from Taiwan's National Health Insurance database. A total of 16,730 patients with newly diagnosed OSA from 2002 to 2008 were recruited and compared with a cohort of 16,730 patients without OSA matched for age, gender, and comorbidities using propensity scoring. All patients were tracked until a diagnosis of PD, death, or the end of 2011.During the mean 5.6-year follow-up period, the incidence rates of PD were 2.30 per 1000 person-years in the OSA cohort and 1.71per 1000 person-years in the comparison group. The incidence rate ratio (IRR) for PD was greater in older patients (≧ 65 years) and male patients with OSA than the controls, respective IRRs being 1.34 and 1.47. After adjustment for the comorbidities, patients with OSA were 1.37 times more likely to have PD than patients without (95% CI = 1.12-1.68, P < 0.05). Subgroup analysis showed that older patients and patients with coronary artery disease, stroke, or chronic kidney disease had a higher risk for PD than their counter parts. Log-rank analysis revealed that patients with OSA had significantly higher cumulative incidence rates of PD than the comparison group (P = 0.0048). Patients with OSA are at an increased risk for subsequent PD, especially elderly male patients.
阻塞性睡眠呼吸暂停（OSA）的特征是反复出现呼吸暂停/低通气和缺氧发作，与全身炎症相关，并诱发代谢、内分泌和心血管疾病。炎症可能对神经退行性疾病产生影响。本研究调查了OSA与帕金森病（PD）之间可能存在的关联。从台湾国民健康保险数据库中收集了100万个体中的随机样本。招募了2002年至2008年新诊断为OSA的16730例患者，并使用倾向评分法与16730例年龄、性别和合并症相匹配的无OSA患者队列进行比较。所有患者均被追踪至诊断为PD、死亡或2011年底。在平均5.6年的随访期内，OSA队列中PD的发病率为每1000人年2.30例，对照组为每1000人年1.71例。老年（≧65岁）OSA患者和男性OSA患者患PD的发病率比（IRR）高于对照组，各自的IRR分别为1.34和1.47。在对合并症进行调整后，OSA患者患PD的可能性是无OSA患者的1.37倍（95%CI = 1.12 - 1.68，P < 0.05）。亚组分析显示，老年患者以及患有冠状动脉疾病、中风或慢性肾病的患者患PD的风险高于对照组。对数秩分析显示，OSA患者的PD累积发病率显著高于对照组（P = 0.0048）。OSA患者随后患PD的风险增加，尤其是老年男性患者。
