Division of Biostatistics and Epidemiology, Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA.
Division of Biostatistics, Department of Research and Development, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India.
Int J Rheum Dis. 2021 Nov;24(11):1354-1361. doi: 10.1111/1756-185X.14178. Epub 2021 Jul 19.
The study aims to recognize the prevalence and possible risk factors of obstructive sleep apnea among individuals with rheumatoid arthritis (RA).
We searched PubMed, Scopus, EMBASE, and Google scholar for potential studies published before the October 30, 2020. The study characteristics, obstructive sleep apnea (OSA) events, and various types of rheumatic diseases were extracted, and the meta-analysis method was used to pool the estimates.
We identified eight studies with 37 285 patients for this meta-analysis. The overall pooled prevalence of OSA was 29.8% (95% confidence interval [CI] 15.2-46.7; I = 99.6%) in the patients with RA. Age was higher in RA patients with OSA but this was not significant. Body mass index (BMI) was significantly associated with OSA in the RA population (standardized mean difference 1.08; P = 0.044). Assessment based on the Berlin Questionnaire for Sleep Apnea resulted in a more precise estimate of OSA prevalence with reduced heterogeneity (prevalence 45.3%; 95% CI 37.4-53.3; I = 58.8%).
Prevalence of OSA among the RA cohort was 29.8% with significant heterogeneity. However, the prevalence was 45.3% when studies were restricted to the OSA diagnosis based on the Berlin questionnaire with very low heterogeneity. Higher BMI is the principal risk factor of OSA development in RA. Hence, controlling BMI could be a preventive strategy for OSA among RA patients.
本研究旨在探讨类风湿关节炎（RA）患者阻塞性睡眠呼吸暂停（OSA）的患病率及可能的危险因素。
我们检索了 PubMed、Scopus、EMBASE 和 Google Scholar 以获取截至 2020 年 10 月 30 日之前发表的潜在研究。提取研究特征、OSA 事件和各种类型的风湿病，并使用荟萃分析方法汇总估计值。
我们确定了 8 项包含 37385 例患者的研究进行荟萃分析。RA 患者的 OSA 总患病率为 29.8%（95%置信区间 15.2%-46.7%；I²=99.6%）。RA 合并 OSA 患者的年龄较高，但差异无统计学意义。BMI 与 RA 人群的 OSA 显著相关（标准化均数差 1.08；P=0.044）。基于柏林睡眠呼吸暂停问卷进行评估可更精确地估计 OSA 患病率，且异质性降低（患病率 45.3%；95%置信区间 37.4%-53.3%；I²=58.8%）。
RA 队列中 OSA 的患病率为 29.8%，存在显著的异质性。然而，当研究仅限于基于柏林问卷的 OSA 诊断时，患病率为 45.3%，异质性非常低。较高的 BMI 是 RA 患者 OSA 发展的主要危险因素。因此，控制 BMI 可能是预防 RA 患者 OSA 的策略。
