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家庭呼吸描记术和肺活量测定术在正常体重和疑似阻塞性睡眠呼吸暂停综合征的肥胖儿童中的应用:是否存在关联?

Home Respiratory Polygraphy and Spirometry in Normal Weight and Children with Obesity Suspected for Obstructive Sleep Apnea Syndrome: Are There Any Associations?

机构信息

Pediatric Pulmonary Unit, Division of Pediatric Specialties, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland.

Pediatric Research Platform, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland.

出版信息

Pulm Med. 2023 Jan 31;2023:1532443. doi: 10.1155/2023/1532443. eCollection 2023.

Abstract

AIM

It is known that children and adolescents with obesity are more prone to obstructive sleep apnea syndrome (OSAS) and that their lung function may show some disturbance. Literature is scarce about potential associations; therefore, we aimed to study the relationship between OSAS, lung function, and adiposity in a population of children suspected of OSAS. . We performed home respiratory polygraphy and spirometry in all subjects. The relationships between body mass index -score (zBMI), polygraphy, and spirometry data were analyzed.

RESULTS

We recruited 81 subjects aged between 5 and 16 years, 63% being obese. 43.2% of subjects were diagnosed with OSAS (32.1% mild, 4.9% moderate, and 6.2% severe). We found no correlation between respiratory polygraphy and the zBMI. The mean spirometric value FEV, FVC, and FEV/FVC ratio 's were normal in all subjects, whereas FVC 's and FEV/FVC ratio 's were significantly positively related for obesity and negatively for normal weight ( < 0.05). FEV 's was inversely correlated to the percentage of analyzed time passed below 90% of SpO ( = -0.224, = 0.044). All subjects with FEV ( = 8) and/or FVC ( = 9) 's below the lower limit for normal (LLN) had an AHI ≥ 1 (FEV: = 0.001; FVC: < 0.001), especially subjects with normal weight (FEV: = 0.003; FVC: = 0.010).

CONCLUSION

When comparing normal-weight children and adolescents with obesity, the prevalence of OSAS but not spirometric values was strongly related to BMI -score, probably because obesity engenders advanced puberty and an accelerated growth spurt. FEV was more frequently <LLN in normal-weight children, while obese subjects presented low FEV/FVC ratio 's and FEF 's. Moreover, all subjects with abnormal spirometric values were suffering from at least mild OSAS, again more frequently in normal-weight subjects.

摘要

目的

众所周知,肥胖儿童和青少年更容易患阻塞性睡眠呼吸暂停综合征(OSAS),且其肺功能可能会出现一些紊乱。关于潜在关联的文献较少;因此,我们旨在研究疑似 OSAS 儿童人群中 OSAS、肺功能和肥胖之间的关系。

方法

我们对所有受试者进行家庭呼吸多导睡眠图和肺量测定。分析了体重指数分数(zBMI)、多导睡眠图和肺量测定数据之间的关系。

结果

我们招募了 81 名年龄在 5 至 16 岁之间的受试者,其中 63%为肥胖者。43.2%的受试者被诊断为 OSAS(轻度 32.1%,中度 4.9%,重度 6.2%)。我们发现呼吸多导睡眠图与 zBMI 之间没有相关性。所有受试者的平均肺量测定值 FEV、FVC 和 FEV/FVC 比值均正常,而肥胖者的 FVC 和 FEV/FVC 比值显著为正相关,正常体重者为负相关(<0.05)。FEV 与 SpO 分析时间中低于 90%的百分比呈负相关(=-0.224,=0.044)。所有 FEV(=8)和/或 FVC(=9)低于正常下限(LLN)的受试者的 AHI≥1(FEV:=0.001;FVC:<0.001),尤其是正常体重的受试者(FEV:=0.003;FVC:=0.010)。

结论

与正常体重的儿童和青少年相比,OSAS 的患病率而不是肺量测定值与 BMI 评分密切相关,这可能是因为肥胖会导致青春期提前和生长突增加速。在正常体重的儿童中,FEV 更常<LLN,而肥胖的受试者则表现出较低的 FEV/FVC 比值和 FEF。此外,所有肺量测定值异常的受试者都患有至少轻度的 OSAS,在正常体重的受试者中更为常见。

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本文引用的文献

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Obesity and childhood asthma.肥胖与儿童哮喘。
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