Department of Geriatrics, Peking University First Hospital, Beijing, 100034, China.
Department of Geriatrics, Peking University First Hospital, Beijing, 100034, China.
Sleep Med. 2021 Jul;83:196-203. doi: 10.1016/j.sleep.2021.02.051. Epub 2021 Mar 3.
Adiposity can have varying effects on the individual depending upon its distribution pattern. We assessed age-related distribution of adipose tissue by anthropometric measures and bioelectrical impedance analysis, as well as their association with obstructive sleep apnea (OSA) severity.
Participants were 169 elderly (aged ≥ 65 years) and 142 non-elderly (aged < 65 years) referred for overnight polysomnography. The associations between obesity parameters and apnea-hypopnea index (AHI) were determine by univariate and multivariate linear regression analyses. Area under receiver operating characteristic curve (AUC) was used to access the predicting performance of some parameters.
Compared with non-elderly, elderly showed higher conicity index and visceral adiposity (VA)/subcutaneous adiposity (SA), lower body mass index (BMI), neck circumference, waist circumference, hip circumference and SA. Multiple regression analyses revealed that VA and VA/SA were independently associated with AHI in elderly (explained 17.2% of the AHI variability), while BMI and VA/SA were independently associated with AHI in non-elderly (explained 25.9% of the AHI variability), after adjusting for age, sex, cigarette smoking, alcohol drinking and main comorbidities. In elderly, VA over 128 cm and VA/SA less than 0.41 resulted in sensitivity, specificity and AUC of 0.382, 0.790, 0.580 and 0.176, 0.947, 0.553 in predicting moderate-to-severe OSA, respectively. In non-elderly, BMI over 24.7 kg/m and VA/SA over 0.54 resulted in sensitivity, specificity and AUC of 0.883, 0.484, 0.704 and 0.550, 0.710, 0.667 in predicting moderate-to-severe OSA, respectively.
VA is strongly associated with OSA severity in elderly, independently of general obesity as per BMI standards, while general adiposity appears to be more strongly associated with OSA severity in non-elderly. Our study supports age-specific approaches should be developed with respect to prediction and treatment of OSA.
体脂分布模式不同，对个体的影响也不同。我们通过人体测量学和生物电阻抗分析评估了与年龄相关的脂肪组织分布，并研究了其与阻塞性睡眠呼吸暂停（OSA）严重程度的关系。
研究对象为 169 名老年（≥65 岁）和 142 名非老年（<65 岁）患者，他们均接受了整夜多导睡眠图检查。通过单变量和多变量线性回归分析确定肥胖参数与呼吸暂停低通气指数（AHI）之间的关系。使用接收者操作特征曲线下面积（AUC）评估某些参数的预测性能。
与非老年组相比，老年组的颈围、腰围、臀围和皮下脂肪（SA）较低，而腰臀比指数和内脏脂肪（VA）/SA 较高，BMI 则较低。多变量回归分析显示，VA 和 VA/SA 与老年组的 AHI 独立相关（解释了 AHI 变异性的 17.2%），而 BMI 和 VA/SA 与非老年组的 AHI 独立相关（解释了 AHI 变异性的 25.9%），这些参数在调整年龄、性别、吸烟、饮酒和主要合并症后具有统计学意义。在老年组中，VA 超过 128cm 和 VA/SA 小于 0.41 预测中重度 OSA 的灵敏度、特异度和 AUC 分别为 0.382、0.790、0.580 和 0.176、0.947、0.553。在非老年组中，BMI 超过 24.7kg/m 和 VA/SA 超过 0.54 预测中重度 OSA 的灵敏度、特异度和 AUC 分别为 0.883、0.484、0.704 和 0.550、0.710、0.667。
VA 与老年患者 OSA 严重程度密切相关，与 BMI 标准下的一般肥胖无关，而在非老年患者中，一般肥胖与 OSA 严重程度的相关性更强。我们的研究支持针对 OSA 的预测和治疗，应制定针对不同年龄的方法。
