Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan.
Cardiovascular Intensive Care Unit, Department of Critical Care Medicine, Far-Eastern Memorial Hospital, New Taipei City 10602, Taiwan.
Int J Environ Res Public Health. 2022 Mar 30;19(7):4118. doi: 10.3390/ijerph19074118.
Objectives: To investigate whether chronic obstructive pulmonary disease (COPD) affects nonapnea sleep disorder (NASD) on the risk of obesity. Materials and Methods: From 1 January 2000 to 31 December 2015, a total of 24,363 patients with obesity from the 2005 Longitudinal Health Insurance Database were identified; 97,452 patients without obesity were also identified from the same database. Multiple logistic regression was used to analyze the previous exposure risk of patients with obesity and NASD. A p value of <0.05 was considered significant. Results: The risk of developing obesity in patients with COPD is 3.05 times higher than that in patients without COPD. Patients with COPD with NASD had a 1.606-fold higher risk of developing obesity than those without NASD. Patients with obesity were more likely to be exposed to NASD than did those without obesity (adjusted odds ratio, 1.693; 95% confidence interval, 1.575−1.821, p < 0.001). Furthermore, the closeness of the exposure period to the index time was positively associated with the severity of obesity, with a dose−response effect. The exposure duration of NASD in patients with obesity was 1.693 times than that in those without obesity. Longer exposure durations were associated with more severe obesity, also with a dose−response effect. Conclusions: The COPD effect of NASD increases the subsequent risk of obesity, and the risk of obesity was determined to be significantly higher in patients with NASD in this case−control study. Longer exposure to NASD was associated with a higher likelihood of obesity, also with a dose−response effect.
探讨慢性阻塞性肺疾病(COPD)是否会影响非呼吸暂停性睡眠障碍(NASD),从而增加肥胖的风险。
2000 年 1 月 1 日至 2015 年 12 月 31 日,从 2005 年纵向健康保险数据库中确定了 24363 例肥胖患者;同时还从同一数据库中确定了 97452 例非肥胖患者。采用多因素 logistic 回归分析肥胖患者发生 NASD 的既往暴露风险。p 值<0.05 认为差异具有统计学意义。
COPD 患者肥胖的风险是无 COPD 患者的 3.05 倍。患有 COPD 合并 NASD 的患者发生肥胖的风险是无 NASD 患者的 1.606 倍。肥胖患者发生 NASD 的可能性大于非肥胖患者(校正优势比,1.693;95%置信区间,1.575−1.821,p<0.001)。此外,暴露期与索引时间的接近程度与肥胖的严重程度呈正相关,存在剂量-反应关系。肥胖患者中 NASD 的暴露持续时间是无肥胖患者的 1.693 倍。暴露时间越长,肥胖越严重,也存在剂量-反应关系。
COPD 合并 NASD 会增加肥胖的后续风险,在本病例对照研究中,患有 NASD 的肥胖患者肥胖的风险明显更高。NASD 暴露时间越长,肥胖的可能性越大,也存在剂量-反应关系。