Department of Pediatrics, Division of Pediatric Cardiology, Children's Hospital at Montefiore/Albert Einstein College of Medicine, Bronx, New York.
Division of Pediatric Cardiology, Department of Pediatrics, Children's Heart Center/Mount Sinai School of Medicine, New York, New York.
Pediatr Pulmonol. 2020 Apr;55(4):1020-1027. doi: 10.1002/ppul.24693. Epub 2020 Feb 18.
To assess the independent relationships of obesity and obstructive sleep apnea (OSA) with hypertension/elevated blood pressure (EBP) in adolescent patients.
A retrospective cohort analysis was performed on 501 patients (age 13-21 years) with three separate blood pressure measurements within 6 months of polysomnography. EBP was defined as average systolic blood pressure (SBP) ≤120 mm Hg; obesity as body mass index Z-score ≤1.65; and OSA as obstructive apnea-hypopnea index <1. Pearson correlations and multivariable analyses were performed to assess the independent effects of the apnea-hypopnea index and body mass index Z-score on SBP.
Of 501 patients (mean age 16 ± 2 years), 246 (49%) were male. OSA was present in 329 (66%) patients, obesity in 337 (67%), and EBP in 262 (52%). EBP was present in 70% of obese adolescents and 60% of adolescents with OSA. Univariable correlation showed a significant relationship between SBP, body mass index Z-score, and apnea-hypopnea index. Multivariable linear regression analysis showed blood pressure was significantly associated with body mass index Z-score (β = .46; P < .01), age (β = .25; P < .01), and height Z-score (β = .14; P < .01), but not apnea-hypopnea index (β = .01; P = .72).
The relationship between OSA and EBP in adolescents is most closely associated with the degree of obesity. Further studies are needed to assess the effect of the treatment of obesity and OSA on blood pressure in adolescents.
评估肥胖和阻塞性睡眠呼吸暂停（OSA）与青少年高血压/血压升高（EBP）的独立关系。
对 501 例（年龄 13-21 岁）多导睡眠图检查后 6 个月内进行了 3 次独立血压测量的患者进行了回顾性队列分析。EBP 定义为平均收缩压（SBP）≤120mmHg；肥胖定义为体质指数 Z 评分≤1.65；OSA 定义为阻塞性呼吸暂停-低通气指数（apnea-hypopnea index，AHI）<1。进行 Pearson 相关性分析和多变量分析，以评估 AHI 和体质指数 Z 评分对 SBP 的独立影响。
501 例患者（平均年龄 16±2 岁）中，246 例（49%）为男性。329 例（66%）患者存在 OSA，337 例（67%）患者肥胖，262 例（52%）患者 EBP。肥胖青少年中 EBP 发生率为 70%，OSA 青少年中 EBP 发生率为 60%。单变量相关性分析显示 SBP、体质指数 Z 评分和 AHI 之间存在显著关系。多变量线性回归分析显示，血压与体质指数 Z 评分（β=0.46；P<0.01）、年龄（β=0.25；P<0.01）和身高 Z 评分（β=0.14；P<0.01）显著相关，但与 AHI 无关（β=0.01；P=0.72）。
青少年 OSA 与 EBP 之间的关系与肥胖程度最密切相关。需要进一步研究评估肥胖和 OSA 治疗对青少年血压的影响。
