Zhu H M, Yi H L, Guan J, Xu H J, Liu S R, Zou J Y, Chen R
Department of Respiratory Medicine，Second Affiliated Hospital of Suzhou University，Suzhou，215004，China.
Department of Otolaryngology Head and Neck Surgery，Shanghai Jiaotong University Affiliated Sixth People's Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Sep;33(9):862-865;869. doi: 10.13201/j.issn.1001-1781.2019.09.016.
To explore the relationship between smoking and the severity of OSA. There were 719 patients included in the study, who were accompanied by snoring, daytime sleepiness and other symptoms. Laboratory-based polysomnographic variables （including AHI, oxygen desaturation index and microarousal index, etc.）, and anthropometric measurements （including weight, neck circumference, waist circumference, hip circumference etc.） were collected for all participants. The severity of OSA was determined by AHI. No OSA was defined as AHI<5, mild OSA as AHI of 5 to 15，moderate OSA as AHI of >15 to 30, and severe OSA as AHI of >30. Smoking severity was determined by the smoking index （SI）. Light smoke was defined as SI<200, moderate smoke was as SI 200 to 400, and severe smoke as SI>400. There were 138 cases of non-OSA and 581 cases of OSA. There were 381 non-smokers, 279 smokers and 59 quit smokers. The smoking rate of OSA group was significantly higher than that of non-OSA group （41.5% vs. 27.5%,<0.01）. After excluding 59 quit smokers, the remaining 660 subjects were divided into four groups according to the severity of smoking, then each group was further divided into four groups according to OSA severity. Unadjusted analysis showed that OSA severity positively correlated with smoking severity （=0.203,<0.01）. The positive correlation remained significant after further adjustment for age, BMI and waist-hip ratio. In addition, logistic regression analysis showed that compared to non-smokers, the odd ratios for OSA in moderate smokers were 1.72 （95% 1.08-2.75） and in severe smokers were 2.68 （95% 1.61-4.46）, after adjustment for age, BMI and waist-hip ratio. The severity of smoking significantly correlated with the severity of OSA. There was increased risk of OSA in patients with severe smoke. The correlation was independent of some confounders such as age and obesity.
为探讨吸烟与阻塞性睡眠呼吸暂停（OSA）严重程度之间的关系。本研究纳入了719例伴有打鼾、日间嗜睡等症状的患者。收集了所有参与者基于实验室的多导睡眠图变量（包括呼吸暂停低通气指数、氧饱和度下降指数和微觉醒指数等）以及人体测量数据（包括体重、颈围、腰围、臀围等）。OSA的严重程度由呼吸暂停低通气指数（AHI）确定。无OSA定义为AHI<5，轻度OSA为AHI 5至15，中度OSA为AHI>15至30，重度OSA为AHI>30。吸烟严重程度由吸烟指数（SI）确定。轻度吸烟定义为SI<200，中度吸烟为SI 200至400，重度吸烟为SI>400。有138例非OSA患者和581例OSA患者。有381例非吸烟者、279例吸烟者和59例戒烟者。OSA组的吸烟率显著高于非OSA组（41.5%对27.5%，<0.01）。排除59例戒烟者后，将其余660名受试者根据吸烟严重程度分为四组，然后每组再根据OSA严重程度进一步分为四组。未校正分析显示，OSA严重程度与吸烟严重程度呈正相关（=0.203，<0.01）。在进一步校正年龄、体重指数（BMI）和腰臀比后，这种正相关仍然显著。此外，逻辑回归分析显示，在校正年龄、BMI和腰臀比后，与非吸烟者相比，中度吸烟者患OSA的比值比为1.72（95% 1.08 - 2.75），重度吸烟者为2.68（95% 1.61 - 4.46）。吸烟严重程度与OSA严重程度显著相关。重度吸烟者患OSA的风险增加。这种相关性独立于年龄和肥胖等一些混杂因素。
