Wang Ling-Uei, Wang Tsung-Yang, Bai Ya-Mei, Hsu Ju-Wei, Huang Kai-Lin, Su Tung-Ping, Li Cheng-Ta, Lin Wei-Chen, Chen Tzeng-Ji, Chen Mu-Hong
Division of Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Forensic and Neurodevelopmental Sciences, London, United Kingdom.
Sleep Med. 2017 Aug;36:44-47. doi: 10.1016/j.sleep.2017.04.016. Epub 2017 May 27.
Previous studies have demonstrated the association between Cushing's syndrome (CS), obstructive sleep apnea (OSA), and the risk factors for OSA, but rarely provided the evidence within a large population. Using the Taiwan National Health Insurance Research Database, we attempted to investigate the association between CS and OSA, and to provide persuading evidences.
In our study, 1612 patients with CS and 1612 age-, sex-, and comorbidities-matched controls were included, and followed up to the end of 2011. Cases of OSA were identified during the follow-up.
Among patients with CS, 53 developed OSA (incidence: 4.11 per thousand person-year) compared with 22 in the control group (incidence: 1.70 per thousand person-year) during the follow-up (p < 0.001). CS patients had a 2.82-fold higher risk of developing OSA (HR = 2.82; 95% CI: 1.67-4.77) in later life.
Our study was the first longitudinal study to support the temporal association between CS and risk of OSA. Patients with CS were associated with an increased likelihood of OSA. Further studies would be required to investigate the exact underlying mechanisms between CS and OSA, and elucidate whether the prompt intervention for CS may reduce the risk of subsequent OSA.
既往研究已证实库欣综合征（CS）、阻塞性睡眠呼吸暂停（OSA）及其危险因素之间存在关联，但很少在大样本人群中提供证据。利用台湾国民健康保险研究数据库，我们试图探究CS与OSA之间的关联，并提供有说服力的证据。
在我们的研究中，纳入了1612例CS患者和1612例年龄、性别及合并症相匹配的对照，并随访至2011年底。随访期间确定OSA病例。
随访期间，CS患者中有53例发生OSA（发病率：每千人年4.11例），而对照组中有22例（发病率：每千人年1.70例）（p<0.001）。CS患者在晚年发生OSA的风险高2.82倍（HR=2.82；95%CI：1.67-4.77）。
我们的研究是首个支持CS与OSA风险之间存在时间关联的纵向研究。CS患者发生OSA的可能性增加。需要进一步研究来探究CS与OSA之间确切的潜在机制，并阐明对CS的及时干预是否可降低随后发生OSA的风险。
