Department of Otorhinolaryngology, Wonju College of Medicine, Yonsei University, Wonju, South Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea.
Sleep Med. 2022 Aug;96:113-118. doi: 10.1016/j.sleep.2022.05.009. Epub 2022 May 18.
Prior research suggests a link between obstructive sleep apnea (OSA) and the likelihood of developing a variety of solid tumors; however, there are no studies assessing OSA and leukemia. This study is the first to identify a potential association between OSA and leukemia using data from the Korea National Health Insurance Service database.
A total of 162,646 patients (≥20 years of age and without any cancer history) newly diagnosed with OSA between 2011 and 2017 were included. A control group of 813,230 subjects was selected using propensity score matching based on age and sex. The mean follow-up time was 4.4 ± 2.0 years. The primary endpoint was newly diagnosed leukemia of any type. The leukemia hazard ratio (95% confidence interval [CI]) was calculated for patients with OSA and compared with that of patients in the control group.
The incidence of leukemia among patients with OSA was significantly higher than that in the controls (1.35 [1.05-1.74]). The hazard ratio was the highest, 1.74 in those under 40 years, and gradually decreased with age, to 1.38 in those aged 40-65 years and 0.96 in those over 65. In particular, the incidence of lymphoid leukemia (2.06 [1.18-3.60]) was higher than that of myeloid (1.34 [1.00-1.81]) or unspecified leukemia (0.60 [0.20-1.58]).
OSA is associated with an increased incidence of leukemia, particularly in patients younger than 40 years of age.
先前的研究表明阻塞性睡眠呼吸暂停（OSA）与多种实体瘤发生的可能性之间存在关联；然而，目前尚无研究评估 OSA 与白血病之间的关系。本研究首次利用韩国国家健康保险服务数据库的数据，确定 OSA 与白血病之间可能存在关联。
共纳入 162646 例（≥20 岁且无任何癌症病史）2011 年至 2017 年新诊断为 OSA 的患者。基于年龄和性别，采用倾向评分匹配法为每位 OSA 患者匹配了 813230 名对照者。平均随访时间为 4.4±2.0 年。主要终点为新发任何类型的白血病。计算 OSA 患者的白血病风险比（95%置信区间[CI]），并与对照组患者进行比较。
OSA 患者的白血病发病率明显高于对照组（1.35[1.05-1.74]）。风险比最高，年龄<40 岁者为 1.74，随年龄增长逐渐降低，年龄 40-65 岁者为 1.38，年龄>65 岁者为 0.96。特别是，淋巴细胞性白血病（2.06[1.18-3.60]）的发病率高于髓性（1.34[1.00-1.81]）或未特指性白血病（0.60[0.20-1.58]）。
OSA 与白血病发病率增加相关，尤其是在年龄<40 岁的患者中。
