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肥胖与非肥胖阻塞性睡眠呼吸暂停患者的临床、生化及多导睡眠图参数比较

Comparison of clinical, biochemical, and polysomnographic parameters between obese and nonobese obstructive sleep apnea.

作者信息

Reddy Sekhar, Koul Parvaiz A, Bhat Moomin Hussain, Shah Sanaullah, Ganie Mohd Ashraf

机构信息

Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.

Department of Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.

出版信息

Lung India. 2022 May-Jun;39(3):261-266. doi: 10.4103/lungindia.lungindia_699_21.

Abstract

BACKGROUND

Obstructive sleep apnea (OSA) occurs in both obese and nonobese individuals. This study was designed to compare clinical, metabolic profile, and polysomnographic parameters among obese and nonobese OSA patients.

MATERIAL AND METHODS

This cross-sectional retro-prospective study involved 148 OSA patients. OSA patients were classified as nonobese (body mass index [BMI] <27.5 kg/m) and obese (BMI ≥27.5 kg/m) to determine the influence of BMI on its risks, clinical, metabolic, and polysomnographic parameters. For statistical comparisons, continuous variables were analyzed by Student's t-test and categorical variables by Chi-square.

RESULTS

Of 148 patients, 106 patients were of a retrospective group and 42 in the prospective group. 116 patients were obese and 32 were nonobese with a mean BMI of 33.66 ± 5.3 versus. 25.17 ± 2.2 kg/m respectively. Female sex (70.7% vs. 43.4%), larger neck circumference (37.99 ± 3.93 vs. 33.67 ± 5.5 cm), loud snoring (94.8% vs. 81.3%), excessive daytime sleepiness (53.4% vs. 9.4%), fatigability (94.8% vs. 75%), high Epworth Sleepiness Scale score (16% vs. 8%), and hypertension (77.6% vs. 46.9%) were significantly (P < 0.05) more common among obese OSA patients while as smoking and sedative use was more prevalent among nonobese OSA group. However, no significant difference in median apnea-hypopnea index and severity of OSA between obese and nonobese group was observed. At the same time, the median oxygen desaturation index was significantly higher in obese patients (26.1 vs. 12.7, P = 0.005).

CONCLUSION

Nonobese OSA patients depicted less severe disease symptoms and thus require high index of suspicion for early identification due to associated cardiovascular risk.

摘要

背景

阻塞性睡眠呼吸暂停(OSA)在肥胖和非肥胖个体中均有发生。本研究旨在比较肥胖和非肥胖OSA患者的临床、代谢特征及多导睡眠图参数。

材料与方法

这项横断面回顾性前瞻性研究纳入了148例OSA患者。根据体重指数(BMI)将OSA患者分为非肥胖组(BMI<27.5kg/m²)和肥胖组(BMI≥27.5kg/m²),以确定BMI对其风险、临床、代谢和多导睡眠图参数的影响。为进行统计学比较,连续变量采用Student's t检验分析,分类变量采用卡方检验分析。

结果

148例患者中,回顾性组有106例,前瞻性组有42例。116例患者为肥胖者,32例为非肥胖者,平均BMI分别为33.66±5.3与25.17±2.2kg/m²。肥胖OSA患者中女性比例(70.7%对43.4%)、颈围更大(37.99±3.93对33.67±5.5cm)、大声打鼾(94.8%对81.3%)、白天过度嗜睡(53.4%对9.4%)、易疲劳(94.8%对75%)、爱泼沃斯思睡量表高分(16%对8%)和高血压(77.6%对46.9%)显著(P<0.05)更常见,而吸烟和使用镇静剂在非肥胖OSA组中更普遍。然而,肥胖组和非肥胖组之间的呼吸暂停低通气指数中位数及OSA严重程度无显著差异。同时,肥胖患者的氧饱和度下降指数中位数显著更高(26.1对12.7,P=0.005)。

结论

非肥胖OSA患者的疾病症状较轻,因此由于存在相关心血管风险,需要高度怀疑以进行早期识别。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c57c/9200199/7bcf276708b4/LI-39-261-g001.jpg

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