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肥胖型阻塞性睡眠呼吸暂停儿童的血液学参数特征

Hematological Parameters Characteristics in Children with Obstructive Sleep Apnea with Obesity.

作者信息

Shen Tian, Wang Jing, Yang Wen, Li Linke, Qiao Yixin, Yan Xiaohong, Chen Min, Tang Xiangdong, Zou Jian, Zhao Yu

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

Department of Otorhinolaryngology Head and Neck Surgery, Chengdu Shangjin Nanfu Hospital, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2021 Mar 11;14:1015-1023. doi: 10.2147/RMHP.S297341. eCollection 2021.

Abstract

OBJECTIVE

To investigate the possible correlation between obesity and hematological parameters in children with obstructive sleep apnea (OSA).

METHODS

A total of 460 children was initially included in our study, which were divided into children with OSA and children without OSA. Multiple analysis was performed for obesity by adjusting confounding factors such as age and gender in 460 children. Further, to minimize the influence of confounding factors and selective bias, propensity score matching (PSM) was performed in children with OSA. Hematological parameters such as inflammatory and coagulable parameters were compared between the normal weight children with OSA and the obese children with OSA following PSM.

RESULTS

OSA (OR = 3.061; <0.001; 95% CI, 1.772-5.288) represented an independent risk factor for obesity. Besides, the obese children with OSA had higher levels of white blood cell (WBC) (<0.001), neutrophil (NEUT) (<0.001), neutrophil-lymphocyte ratio (NLR) (=0.006), fibrinogen (FIB) (=0.033), while had a lower level of activated partial thromboplastin time (APTT) (=0.048). No significant differences were observed in other hematological parameters. In linear regression, the results indicated that the levels of WBC (R = 0.123, Beta = 0.289, P<0.001), NEUT (R = 0.124, Beta = 0.282, P<0.001), NLR (R = 0.105, Beta = 0.184, P=0.026) and FIB (R = 0.086, Beta = 0.246, P=0.003) were positively correlated with BMI, while the level of APTT (R = 0.057, Beta = -0.171, P=0.044) was significantly negatively correlated with BMI.

CONCLUSION

OSA was an independent risk factor contributing to obesity. WBC, NEUT, NLR, FIB and APTT are correlated with obesity in children with OSA (aged from 2 to 14 years). These indicators could be used to estimate the status of inflammation and hypercoagulation in the obese children with OSA.

摘要

目的

探讨阻塞性睡眠呼吸暂停(OSA)患儿肥胖与血液学参数之间可能存在的相关性。

方法

本研究最初纳入了460名儿童,将其分为OSA患儿和非OSA患儿。对460名儿童的肥胖情况进行多因素分析,调整年龄和性别等混杂因素。此外,为尽量减少混杂因素和选择性偏倚的影响,对OSA患儿进行倾向得分匹配(PSM)。在PSM后,比较正常体重的OSA患儿和肥胖的OSA患儿之间的血液学参数,如炎症和凝血参数。

结果

OSA(OR = 3.061;<0.001;95%CI,1.772 - 5.288)是肥胖的独立危险因素。此外,肥胖的OSA患儿白细胞(WBC)水平更高(<0.001)、中性粒细胞(NEUT)水平更高(<0.001)、中性粒细胞与淋巴细胞比值(NLR)更高(=0.006)、纤维蛋白原(FIB)水平更高(=0.033),而活化部分凝血活酶时间(APTT)水平更低(=0.048)。其他血液学参数未观察到显著差异。在线性回归中,结果表明WBC水平(R = 0.123,Beta = 0.289,P<0.001)、NEUT水平(R = 0.124,Beta = 0.282,P<0.001)、NLR水平(R = 0.105,Beta = 0.184,P = 0.026)和FIB水平(R = 0.086,Beta = 0.246,P = 0.003)与BMI呈正相关,而APTT水平(R = 0.057,Beta = -0.171,P = 0.044)与BMI呈显著负相关。

结论

OSA是导致肥胖的独立危险因素。WBC、NEUT、NLR、FIB和APTT与2至14岁的OSA患儿肥胖相关。这些指标可用于评估肥胖的OSA患儿的炎症和高凝状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d97/7961133/8aaec628f01e/RMHP-14-1015-g0001.jpg

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