Division of Pulmonology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Division of Allergy, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
PLoS One. 2020 Oct 5;15(10):e0239963. doi: 10.1371/journal.pone.0239963. eCollection 2020.
Interstitial lung diseases (ILDs) are chronic, progressive, parenchymal lung diseases with high morbidity and mortality. In recent studies, the prevalence of obstructive sleep apnea (OSA) in patients with ILD has been reported to be high. However, the prevalence and predictive factors of OSA in Korean ILD patients are not well defined. Therefore, the aim of this study was to evaluate the prevalence and predictive factors of OSA in Korean patients with ILD. Clinical data from 86 patients with ILD enrolled from December 2017 to April 2019 at Haeundae-Paik Hospital, Busan, South Korea, were retrospectively analyzed. OSA was monitored with a level 4 portable device and defined as an apnea-hypopnea index of more than 5 per hour of sleep. The median follow-up period was 7 months. The mean age was 69.8 years, and 64% of participants were men. Among the ILDs, idiopathic pulmonary fibrosis (IPF) was the most common (66.3%), followed by connective tissue disease-associated ILD (16.3%) and cryptogenic organizing pneumonia (5.8%). Forty-six ILD patients (53.5%) were diagnosed with OSA, and IPF patients had OSA more frequently (64.9% vs. 31.0%, p = 0.003) than those with other ILDs. Older age (odds ratio [OR], 1.11, 95% CI 1.04-1.19, p = 0.002), higher body weight (OR 1.05, 95% CI 1.01-1.10, p = 0.012), and diabetes mellitus (OR 4.03, 95% CI 1.26-12.91, p = 0.019) were independent risk factors for OSA in the multivariable logistic regression analysis. In the multivariable Cox analysis, an IPF diagnosis was a significant risk factor for one-year mortality (hazard ratio [HR] 7.92, 95% CI: 1.01-61.83, p = 0.048) in ILD patients; however, OSA was not. In conclusion, half of Korean patients with ILD had OSA. Older age, higher body weight, and diabetes mellitus were risk factors for OSA in patients with ILD.
间质性肺疾病（ILDs）是一种慢性、进行性的实质肺疾病，发病率和死亡率均较高。最近的研究表明，ILD 患者阻塞性睡眠呼吸暂停（OSA）的患病率较高。然而，韩国 ILD 患者 OSA 的患病率和预测因素尚未得到明确界定。因此，本研究旨在评估韩国 ILD 患者 OSA 的患病率和预测因素。
本研究回顾性分析了 2017 年 12 月至 2019 年 4 月在韩国釜山海云台拜克医院就诊的 86 例 ILD 患者的临床资料。使用 4 级便携式设备监测 OSA，并将睡眠中每小时呼吸暂停低通气指数超过 5 定义为 OSA。中位随访时间为 7 个月。患者平均年龄为 69.8 岁，64%为男性。ILD 中最常见的是特发性肺纤维化（IPF）（66.3%），其次是结缔组织病相关 ILD（16.3%）和隐源性机化性肺炎（5.8%）。46 例（53.5%）ILD 患者诊断为 OSA，IPF 患者 OSA 的患病率高于其他 ILD 患者（64.9%比 31.0%，p=0.003）。多变量逻辑回归分析显示，年龄较大（比值比[OR]，1.11；95%置信区间[CI]，1.04-1.19；p=0.002）、体重较高（OR，1.05；95%CI，1.01-1.10；p=0.012）和糖尿病（OR，4.03；95%CI，1.26-12.91；p=0.019）是 OSA 的独立危险因素。多变量 Cox 分析显示，IPF 诊断是 ILD 患者一年死亡率的显著危险因素（风险比[HR]，7.92；95%CI：1.01-61.83；p=0.048），而 OSA 不是。
总之，一半的韩国 ILD 患者患有 OSA。年龄较大、体重较高和糖尿病是 ILD 患者 OSA 的危险因素。
