Department of Internal Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, 593 Eddy Street, Jane Brown Ground, Suite 0100, Providence, RI, USA.
Division of Gastroenterology, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Dig Dis Sci. 2021 Nov;66(11):3689-3697. doi: 10.1007/s10620-020-06709-1. Epub 2020 Nov 25.
Obstructive sleep apnea (OSA) has gastrointestinal implications as it is associated with gastroesophageal reflux disease. Less certain is an independent association between OSA and Barrett's esophagus. We performed a systematic review and meta-analysis to evaluate the association between OSA and Barrett's esophagus.
A systematic search of Ovid MEDLINE, Embase, Web of Science, CINAHL, and the Cochrane Central Register of Controlled Trials was performed. Inclusion criteria were observational studies (retrospective and case-control) assessing the association between OSA and Barrett's esophagus in adult subjects. Data from the included studies were extracted and used to calculate the pooled odds ratio of OSA with 95% confidence interval (CI) between patients with Barrett's esophagus and those without, using a random-effects model.
Altogether six studies involving 2333 subjects met the inclusion criteria and were included in this meta-analysis. The pooled analysis found a significantly increased risk of OSA, high risk of OSA, and patient-reported OSA symptoms among patients with Barrett's esophagus versus those without Barrett's esophagus, with a pooled odds ratio (OR) of 2.19 (95% CI 1.53-3.15). A subgroup analysis for cases of definite OSA (formally diagnosed via polysomnography) and Barrett's esophagus (n = 2 studies) also demonstrated significant association (OR 2.59, 95% CI 1.39-4.84).
A significantly increased risk of OSA among patients with Barrett's esophagus was demonstrated in this meta-analysis. Further investigation is warranted to determine the pathophysiology and clinical implications of this association.
阻塞性睡眠呼吸暂停（OSA）与胃食管反流病有关，因此对胃肠道有影响。但 OSA 与巴雷特食管之间是否存在独立关联尚不确定。我们进行了系统评价和荟萃分析，以评估 OSA 和巴雷特食管之间的关联。
对 Ovid MEDLINE、Embase、Web of Science、CINAHL 和 Cochrane 对照试验中心注册库进行了系统搜索。纳入标准为评估成人 OSA 与巴雷特食管之间关联的观察性研究（回顾性和病例对照研究）。提取纳入研究的数据，并使用随机效应模型计算巴雷特食管患者与无巴雷特食管患者之间 OSA 的合并优势比（OR）及其 95%置信区间（CI）。
共有 6 项研究纳入了 2333 名受试者，符合纳入标准并纳入本荟萃分析。汇总分析发现，与无巴雷特食管者相比，巴雷特食管患者的 OSA、高危 OSA 和患者报告的 OSA 症状的风险显著增加，合并 OR 为 2.19（95%CI 1.53-3.15）。针对明确 OSA（通过多导睡眠图正式诊断）和巴雷特食管病例（n=2 项研究）的亚组分析也显示出显著相关性（OR 2.59，95%CI 1.39-4.84）。
本荟萃分析表明，巴雷特食管患者 OSA 的风险显著增加。需要进一步研究以确定这种关联的病理生理学和临床意义。
