中国习惯性打鼾与心血管疾病的年龄特异性关联：一项10年队列研究。
Age-Specific Associations Between Habitual Snoring and Cardiovascular Diseases in China: A 10-Year Cohort Study.
作者信息
Wei Yuxia, Lv Jun, Guo Yu, Bian Zheng, Fan Junning, Du Huaidong, Yang Ling, Chen Yiping, Qin Yulu, Wang Ping, Chen Junshi, Chen Zhengming, Yu Canqing, Li Liming
机构信息
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences, Peking University, Ministry of Education, Beijing, China; Peking University Institute of Environmental Medicine, Beijing, China.
出版信息
Chest. 2021 Sep;160(3):1053-1063. doi: 10.1016/j.chest.2021.04.070. Epub 2021 May 21.
BACKGROUND
Limited convincing evidence is available of the relationship between habitual snoring and cardiovascular diseases (CVDs).
RESEARCH QUESTION
Is habitual snoring associated with total CVD and CVD subtypes in different age groups of Chinese adults?
STUDY DESIGN AND METHODS
The China Kadoorie Biobank study enrolled more than 0.5 million adults aged 30 to 79 years from 10 regions in China. Snoring status and other baseline characteristics were collected from 2004 to 2008, using an interviewer-administered laptop-based questionnaire. The current analysis included 489,583 participants without stroke or coronary heart disease at baseline. Cox proportional hazards models were used to calculate the adjusted hazard ratios (HRs) and 95% CIs of cardiovascular diseases (CVDs) for habitual snoring vs nonhabitual snoring.
RESULTS
During a median follow-up of 9.6 years, 130,935 participants developed CVDs. Associations between habitual snoring and CVDs varied with age. Among participants aged younger than 50 years at baseline, habitual snoring was associated with an increased risk of total CVD (HR, 1.11; 95% CI, 1.07-1.14) after adjustment for known CVD risk factors, including systolic BP. The corresponding HRs (95% CIs) for ischemic heart disease, ischemic stroke, and hemorrhagic stroke were 1.18 (1.12-1.24), 1.12 (1.05-1.19), and 1.05 (0.92-1.19), respectively. However, such associations in adults aged 50 to 64 years were much weaker, and no statistically significant association was observed among individuals aged ≥65 years. Age-specific risk estimates were generally similar across sex and obesity subgroups.
INTERPRETATION
Habitual snoring was associated with increased risks of total CVD, ischemic heart disease, ischemic stroke, but not hemorrhagic stroke in Chinese, and these associations were mainly limited to those aged <50 years. Clinicians in China are encouraged to identify snoring, particularly in younger adults.
背景
关于习惯性打鼾与心血管疾病（CVD）之间的关系，现有的确凿证据有限。
研究问题
在中国成年人的不同年龄组中，习惯性打鼾与总的心血管疾病及心血管疾病亚型是否相关？
研究设计与方法
中国嘉道理生物银行研究纳入了来自中国10个地区的50多万名30至79岁的成年人。2004年至2008年期间，通过访员使用基于笔记本电脑的问卷收集打鼾状况及其他基线特征。当前分析纳入了489,583名基线时无中风或冠心病的参与者。采用Cox比例风险模型计算习惯性打鼾与非习惯性打鼾相比的心血管疾病（CVD）的校正风险比（HR）和95%置信区间（CI）。
结果
在中位随访9.6年期间，130,935名参与者发生了心血管疾病。习惯性打鼾与心血管疾病之间的关联因年龄而异。在基线年龄小于50岁的参与者中，在调整了包括收缩压在内的已知心血管疾病危险因素后，习惯性打鼾与总的心血管疾病风险增加相关（HR，1.11；95%CI，1.07 - 1.14）。缺血性心脏病、缺血性中风和出血性中风的相应HR（95%CI）分别为1.18（1.12 - 1.24）、1.12（1.05 - 1.19）和1.05（0.92 - 1.19）。然而，在50至64岁的成年人中，这种关联要弱得多，在年龄≥65岁的个体中未观察到统计学上的显著关联。特定年龄的风险估计在性别和肥胖亚组中总体相似。
解读
在中国，习惯性打鼾与总的心血管疾病、缺血性心脏病、缺血性中风的风险增加相关，但与出血性中风无关，且这些关联主要限于年龄<50岁的人群。鼓励中国的临床医生识别打鼾情况，尤其是在年轻成年人中。
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