Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua, Taiwan.
Digestive Disease Center, Changbing Show-Chwan Memorial Hospital, Lukang, Changhua County, Taiwan.
Sleep Breath. 2019 Mar;23(1):355-362. doi: 10.1007/s11325-018-1696-5. Epub 2018 Jul 7.
To assess the association between obstructive sleep apnea (OSA) and gallstones.
We identified 3827 patients aged ≥ 20 years with OSA between 2000 and 2010 from the Longitudinal Health Insurance Research Database 2000 (LHID2000) as the study cohort. The beneficiaries without OSA were randomly selected and propensity-matched with the study cohort in a 1:1 ratio according to age; sex; occupation; urbanization; comorbidities of hypothyroidism, hyperlipidemia, diabetes, liver cirrhosis, alcohol-related illness, hypertension, chronic obstructive pulmonary disease (COPD), obesity, inflammatory bowel disease, stroke, coronary artery disease (CAD), hepatitis B virus, and hepatitis C virus; and the index year. All patients were followed until the end of 2011 or withdrawal from the National Health Insurance program to determine the incidence of gallstones.
The prevalence of OSA was higher in men (67.3%) and in patients younger than 49 years (57.0%; mean age 47.8 ± 15.1 years). The cumulative incidence of gallstones was higher in the OSA cohort than in the non-OSA cohort (log-rank test, P < 0.001). Compared with patients without OSA, those with OSA had an increased risk of gallstones (adjusted hazard ratio = 1.53, 95% confidence interval = 1.16-2.03) after adjustment for age, sex, hyperlipidemia, diabetes, hypertension, COPD, stroke, and CAD.
The study shows a strong association between OSA and gallstones. Moreover, our findings suggest the requirement for survey and health education for gallstones in OSA and further studies to verify whether the treatment of OSA can reduce the risk of gallstones.
评估阻塞性睡眠呼吸暂停（OSA）与胆囊结石的关系。
我们从 2000 年至 2010 年的纵向健康保险研究数据库 2000（LHID2000）中确定了 3827 名年龄≥20 岁的 OSA 患者作为研究队列。根据年龄、性别、职业、城市化程度、甲状腺功能减退、高脂血症、糖尿病、肝硬化、酒精相关疾病、高血压、慢性阻塞性肺疾病（COPD）、肥胖、炎症性肠病、中风、冠心病（CAD）、乙型肝炎病毒和丙型肝炎病毒合并症以及索引年，对无 OSA 的受益人与研究队列进行 1:1 比例的随机选择和倾向匹配。所有患者均随访至 2011 年底或退出国家健康保险计划，以确定胆囊结石的发生率。
OSA 在男性（67.3%）和 49 岁以下患者（57.0%；平均年龄 47.8±15.1 岁）中更为常见。OSA 队列的胆囊结石累积发生率高于非 OSA 队列（对数秩检验，P<0.001）。与无 OSA 的患者相比，调整年龄、性别、高脂血症、糖尿病、高血压、COPD、中风和 CAD 后，患有 OSA 的患者发生胆囊结石的风险增加（调整后的危险比=1.53，95%置信区间=1.16-2.03）。
本研究表明 OSA 与胆囊结石之间存在很强的关联。此外，我们的研究结果表明，需要对 OSA 患者进行胆囊结石调查和健康教育，并进一步研究以验证 OSA 的治疗是否可以降低胆囊结石的风险。
