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探讨中国轻中度阻塞性睡眠呼吸暂停低通气综合征患儿肥胖与认知障碍的相关性。

Exploration of the Association Between Obesity and Cognitive Impairment in Chinese Children with Mild or Moderate Obstructive Sleep Apnea-Hypopnea Syndrome.

机构信息

Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

J Pediatr Nurs. 2020 Jul-Aug;53:36-40. doi: 10.1016/j.pedn.2020.03.013. Epub 2020 May 12.

Abstract

PURPOSE

To explore the association between obesity and cognitive impairment in children with mild or moderate obstructive sleep apnea-hypopnea syndrome (OSAHS).

DESIGN AND METHODS

A total of 71 children with obesity and 71 age- and sex- matched children who were non-obese were included. The Wechsler Intelligence Scale for Children fourth edition (WISC-IV) was adopted to evaluate the cognition of the participating children. Pearson and partial correlation analysis were performed to investigate the relationships between neurocognitive functions and demographic and polysomnography parameters. Two-way Analysis of Variance was performed to evaluate the effect of obesity and apnea-hypopnea index (AHI) on cognitive functions.

RESULTS

Full-scale intelligence quotient (FSIQ, 92.4 ± 12.3 vs. 98.6 ± 13.1; P < 0.01), verbal comprehension index (VCI, 92.8 ± 10.8 vs. 98.7 ± 10.9; P < 0.01), working memory index (WMI, 92.6 ± 11.3 vs. 96.5 ± 11.0; P = 0.04) and perceptual reasoning index (PRI, 93.8 ± 12.1 vs. 99.2 ± 12.5; P < 0.01) were significantly lower in the children with obesity compared with those in the control group. Partial correlation analysis showed that FSIQ were negatively and significantly correlated with body mass index (BMI, r = -0.347, P < 0.01) and AHI (r = -0.304, P < 0.01). Two-way ANOVA revealed that both obesity and AHI had independent effects on FSIQ (both P < 0.05). The interaction between the effect of obesity and AHI on cognitive functions was not significant, indicating that obesity is a risk factor of cognitive impairment independent of AHI.

CONCLUSIONS

Obesity aggravates cognitive impairment in children with mild or moderate OSAHS.

PRACTICE IMPLICATIONS

Children diagnosed with OSAHS and obesity are recommended to control their body weight for the prevention, management and treatment of cognitive impairment.

摘要

目的

探讨轻度或中度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿肥胖与认知障碍的关系。

方法

纳入 71 例肥胖患儿和 71 例年龄、性别匹配的非肥胖患儿。采用韦氏儿童智力量表第四版(WISC-IV)评估患儿认知功能。采用 Pearson 和偏相关分析探讨神经认知功能与人口统计学和多导睡眠图参数的关系。采用双因素方差分析评估肥胖和呼吸暂停低通气指数(AHI)对认知功能的影响。

结果

全智商(FSIQ,92.4±12.3 比 98.6±13.1;P<0.01)、言语理解指数(VCI,92.8±10.8 比 98.7±10.9;P<0.01)、工作记忆指数(WMI,92.6±11.3 比 96.5±11.0;P=0.04)和知觉推理指数(PRI,93.8±12.1 比 99.2±12.5;P<0.01)肥胖组患儿均显著低于对照组。偏相关分析显示,FSIQ 与体重指数(BMI,r=-0.347,P<0.01)和 AHI(r=-0.304,P<0.01)呈负相关。双因素方差分析显示,肥胖和 AHI 均对 FSIQ 有独立影响(均 P<0.05)。肥胖和 AHI 对认知功能的影响之间无交互作用,表明肥胖是 AHI 以外认知障碍的危险因素。

结论

肥胖加重了轻度或中度 OSAHS 患儿的认知障碍。

实践意义

建议患有 OSAHS 和肥胖的患儿控制体重,以预防、管理和治疗认知障碍。

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