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非传染性疾病诊所中发生阻塞性睡眠呼吸暂停风险的患者的严重程度和决定因素。

Magnitude and Determinants of Patients at Risk of Developing Obstructive Sleep Apnea in a Non-Communicable Disease Clinic.

机构信息

Department of Community Medicine, Indira Gandhi Medical College & Research Institute, Kathirkamam, Vazhudavur Road, Puducherry 605010, India.

Department of Community Medicine, Government Thiruvannamalai Medical College & Hospital, Thiruvannamalai 606604, India.

出版信息

Medicina (Kaunas). 2019 Jul 20;55(7):391. doi: 10.3390/medicina55070391.


DOI:10.3390/medicina55070391
PMID:31330779
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6681367/
Abstract

: Obstructive sleep apnea (OSA) is a common chronic disorder worldwide, which can adversely affect the cardiovascular system among non-communicable disease (NCD) patients. It is underdiagnosed-or rather not diagnosed-in primary care settings due to the costly diagnostic techniques involved. This study aimed to assess the number of study participants at risk of developing OSA and to assess and quantify the risk factors associated with this disorder. : A cross-sectional study was performed in an NCD clinic of a rural health training center, Karikalampakkam, Puducherry of South India from August 2018 to October 2018. A Modified Berlin Questionnaire (MBQ) was used to screen the study participants at risk for OSA. Four-hundred-and-seventy-three people aged 18 years and above were included in the study, using systematic random sampling. Respondents' socio-demographic and morbidity characteristics, as well as clinical and anthropometric parameters including body weight, height, blood pressure, neck, hip and waist circumference were collected. Data was captured using Epicollect5 and analyzed using SPSS version 20.0. One-fourth (25.8%) of the respondents were at high risk of developing OSA. In terms of gender, 27.9% of the men and 23.8% of the women were at high risk for OSA. In univariate analyses, the risk of developing OSA was significantly associated with a history of diabetes mellitus, hypertension, dyslipidemia and gastro-esophageal reflux disease, weight, body mass index, neck, waist and hip circumference, waist-hip ratio, and systolic and diastolic blood pressure. Multivariate logistic regression analysis showed that a history of dyslipidemia (aOR, 95% CI = 2.34, 1.22-4.48), body mass index (aOR, 95% CI = 1.15, 1.06-1.22) and waist circumference (aOR, 95% CI = 1.10, 1.07-1.14) emerged as significant predictors of risk for OSA. A considerable proportion of NCD patients with easily detectable attributes are at risk of developing OSA, but still remain undiagnosed at a primary health care setting. The results obtained using MBQ in this study were comparable to studies performed using polysomnography. Dyslipidemia, body mass index and waist circumference were independent risk factors for predicting a risk of developing OSA. Prospective studies are needed to confirm whether a reduction in these risk factors could reduce the risk for OSA.

摘要

阻塞性睡眠呼吸暂停(OSA)是一种常见的全球慢性疾病,它会对非传染性疾病(NCD)患者的心血管系统造成不利影响。由于涉及到昂贵的诊断技术,这种疾病在初级保健环境中被漏诊或未被诊断。本研究旨在评估患有 OSA 的研究参与者的数量,并评估和量化与这种疾病相关的风险因素。

本研究为横断面研究,于 2018 年 8 月至 10 月在印度南部 Puducherry 的 Karikalampakkam 农村卫生培训中心的 NCD 诊所进行。使用改良柏林问卷(MBQ)对有 OSA 风险的研究参与者进行筛查。采用系统随机抽样的方法,纳入了 473 名年龄在 18 岁及以上的研究对象。收集了受访者的社会人口统计学和发病特征,以及临床和人体测量参数,包括体重、身高、血压、颈围、臀围和腰围。使用 Epicollect5 采集数据,并使用 SPSS 版本 20.0 进行分析。四分之一(25.8%)的受访者有发生 OSA 的高风险。就性别而言,27.9%的男性和 23.8%的女性有发生 OSA 的高风险。在单因素分析中,发生 OSA 的风险与糖尿病、高血压、血脂异常和胃食管反流病、体重、体重指数、颈围、腰围和臀围、腰臀比以及收缩压和舒张压等病史显著相关。多因素逻辑回归分析显示,血脂异常史(比值比[OR],95%置信区间[CI] = 2.34,1.22-4.48)、体重指数(OR,95%CI = 1.15,1.06-1.22)和腰围(OR,95%CI = 1.10,1.07-1.14)是发生 OSA 的显著风险预测因子。

具有易察觉特征的相当一部分 NCD 患者有发生 OSA 的风险,但在初级卫生保健环境中仍未被诊断出来。本研究中使用 MBQ 获得的结果与使用多导睡眠图进行的研究相似。血脂异常、体重指数和腰围是预测发生 OSA 风险的独立危险因素。需要前瞻性研究来证实是否可以降低这些风险因素来降低 OSA 的风险。

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引用本文的文献

[1]
Change in the Constricted Airway in Patients after Clear Aligner Treatment: A Retrospective Study.

Diagnostics (Basel). 2022-9-11

[2]
Obstructive Sleep Apnea: A View from the Back Door.

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本文引用的文献

[1]
Screening for High Risk of Sleep Apnea in an Ambulatory Care Setting in Saudi Arabia.

Int J Environ Res Public Health. 2019-2-5

[2]
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Lancet Glob Health. 2018-12

[3]
Obstructive sleep apnoea independently predicts lipid levels: Data from the European Sleep Apnea Database.

Respirology. 2018-8-21

[4]
A Population-Based Study of the Bidirectional Association Between Obstructive Sleep Apnea and Type 2 Diabetes in Three Prospective U.S. Cohorts.

Diabetes Care. 2018-8-2

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Curr Drug Metab. 2018

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J Glob Health. 2018-6

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Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis.

Sleep Med. 2018-1-3

[10]
High Prevalence of Obstructive Sleep Apnea among People with Type 2 Diabetes Mellitus in a Tertiary Care Center.

J Assoc Physicians India. 2017-11

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