Department of Otolaryngology-Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Otolaryngology-Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Clin Cardiol. 2023 Jan;46(1):92-99. doi: 10.1002/clc.23941. Epub 2022 Nov 20.
It is unclear about the cardiovascular and metabolic diseases (CMD) among Chinese patients with different clinical subtypes of obstructive sleep apnea (OSA).
The prevalence of CMD varies among OSA patients of different clinical subtypes.
A total of 1483 Chinese patients with OSA were assessed to evaluate the existence of clinical subtypes of OSA using latent class analysis. We compared the differences in demographic characteristics and prevalence of CMD using ANOVA and χ tests. Associations between clinical subtypes and disease prevalence were assessed using adjusted logistic regression.
We identified prevalent CMD in Chinese patients with the four subtypes of OSA: excessively sleepy (ES), moderately sleepy with disturbed sleep (ModSwDS), moderately sleepy (ModS), and minimally symptomatic (MinS). The ES subtype had a higher body mass index, average Epworth Sleepiness Scale score, Apnea-hypopnea index, and oxyhemoglobin saturation below 90% compared with the other subtypes (p < .05). The MinS subtype had the lowest mean ESS score (p < .05). We found a significant difference in the prevalence of CMD among the four subtypes, with the highest proportion of cases of CMD in the ES subtype. In adjusted models, significant associations with CMD were also found. ES, ModSwDS, ModS, and MinS subtypes are very high-risk, high-risk, medium-risk, and low-risk in prevalent CMD.
This study identified four clinical subtypes of OSA in Chinese patients. Each clinical subtype corresponds with a different level of prevalence of CMD; this finding is helpful for the more precise treatment of patients with different clinical manifestations.
不同临床亚型阻塞性睡眠呼吸暂停（OSA）的中国患者中心血管和代谢疾病（CMD）的发病情况尚不清楚。
不同临床亚型 OSA 患者的 CMD 患病率不同。
对 1483 例中国 OSA 患者进行评估，采用潜在类别分析评估 OSA 患者的临床亚型。使用方差分析和 χ 检验比较不同临床亚型患者的人口统计学特征和 CMD 患病率差异。使用调整后的 logistic 回归评估临床亚型与疾病患病率之间的关联。
我们确定了中国四种 OSA 亚型患者中常见的 CMD：过度嗜睡（ES）、睡眠障碍伴中度嗜睡（ModSwDS）、中度嗜睡（ModS）和轻度症状（MinS）。ES 亚型的体重指数、平均 Epworth 嗜睡量表评分、呼吸暂停低通气指数和 90%以下的氧合血红蛋白饱和度均高于其他亚型（p < .05）。MinS 亚型的 ESS 评分最低（p < .05）。我们发现四种亚型中 CMD 的患病率存在显著差异，ES 亚型的 CMD 病例比例最高。在调整后的模型中，也发现了与 CMD 显著相关的因素。ES、ModSwDS、ModS 和 MinS 亚型在 CMD 患病率方面分别为极高风险、高风险、中风险和低风险。
本研究在中国患者中确定了四种 OSA 临床亚型。每种临床亚型都对应着不同程度的 CMD 患病率；这一发现有助于对具有不同临床表现的患者进行更精确的治疗。
