Division of Surgery, Department of Surgery & Cancer, Imperial College London, Academic Surgical Unit, 10th Floor QEQM, St Mary's Hospital, South Wharf Road, London, W2 1NY, UK.
Department of Otolaryngology, Head and Neck Surgery, Imperial College Healthcare NHS Trust, London, W2 1NY, UK.
Obes Surg. 2021 May;31(5):1986-1993. doi: 10.1007/s11695-020-05196-7. Epub 2021 Jan 9.
Obstructive sleep apnea (OSA) is an increasingly common disorder associated with increased cardiovascular disease, mortality, reduced productivity, and an increased risk of road traffic accidents. A significant proportion of patients with OSA in the UK are undiagnosed. This study aims to identify risk factors for OSA in an obese cohort.
A population-based study was conducted of obese patients (BMI ≥ 30 kg/m) from the Clinical Practice Research Datalink (CPRD). A logistic regression model was used to calculate odds ratios (ORs) for developing OSA according to other clinicopathological characteristics. Multivariate analysis was conducted of individual factors that affect the propensity to develop OSA. Statistical significance was defined as p < 0.050.
From 276,600 obese patients identified during a data extraction of the CPRD in July 2017, the prevalence of OSA was 5.4%. The following risk factors were found to be independently associated with increased likelihood of OSA: male sex (OR = 3.273; p < 0.001), BMI class II (OR = 1.640; p < 0.001), BMI class III (OR = 3.768; p < 0.001), smoking (OR = 1.179; p < 0.001), COPD (OR = 1.722; p < 0.001), GERD (OR = 1.557; p < 0.001), hypothyroidism (OR = 1.311; p < 0.001), acromegaly (OR = 3.543; p < 0.001), and benzodiazepine use (OR = 1.492; p < 0.001). Bariatric surgery was associated with reduced risk of OSA amongst this obese population (OR = 0.260; p < 0.001).
In obese patients, there are numerous comorbidities that are associated with increased likelihood of OSA. These factors can help prompt clinicians to identify undiagnosed OSA. Bariatric surgery appears to be protective against developing OSA.
阻塞性睡眠呼吸暂停（OSA）是一种越来越常见的疾病，与心血管疾病、死亡率增加、生产力降低以及道路交通事故风险增加有关。在英国，相当一部分 OSA 患者未被诊断出来。本研究旨在确定肥胖患者群体中 OSA 的风险因素。
对临床实践研究数据库（CPRD）中肥胖患者（BMI≥30kg/m²）进行基于人群的研究。使用逻辑回归模型根据其他临床病理特征计算发生 OSA 的比值比（OR）。对影响发生 OSA 倾向的个体因素进行多变量分析。统计学意义定义为 p<0.050。
在 2017 年 7 月对 CPRD 进行数据提取期间，从 276600 名肥胖患者中发现 OSA 的患病率为 5.4%。发现以下风险因素与 OSA 发生的可能性增加独立相关：男性（OR=3.273；p<0.001）、BMI Ⅱ级（OR=1.640；p<0.001）、BMI Ⅲ级（OR=3.768；p<0.001）、吸烟（OR=1.179；p<0.001）、COPD（OR=1.722；p<0.001）、GERD（OR=1.557；p<0.001）、甲状腺功能减退症（OR=1.311；p<0.001）、肢端肥大症（OR=3.543；p<0.001）和苯二氮䓬类药物使用（OR=1.492；p<0.001）。在肥胖人群中，减重手术与 OSA 风险降低相关（OR=0.260；p<0.001）。
在肥胖患者中，有许多合并症与 OSA 发生的可能性增加有关。这些因素可以帮助临床医生识别未被诊断的 OSA。减重手术似乎可以预防 OSA 的发生。
