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血清 25-羟维生素 D、肥胖与新发阻塞性睡眠呼吸暂停的关系。

Relationship of serum 25-hydroxyvitamin D, obesity with new-onset obstructive sleep apnea.

机构信息

Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, 510515, China.

出版信息

Int J Obes (Lond). 2024 Feb;48(2):218-223. doi: 10.1038/s41366-023-01402-5. Epub 2023 Oct 27.

Abstract

OBJECTIVE

The prospective association between vitamin D and obstructive sleep apnea (OSA) remains uncertain. We aimed to assess the association between serum 25-hydroxyvitamin D (25(OH)D), a major circulating form of vitamin D, and new-onset OSA, and examine the modifying effect of obesity.

MATERIALS AND METHODS

This prospective cohort study included 444,975 participants from UK Biobank without prior OSA. The primary outcome was new-onset OSA.

RESULTS

During a median follow-up duration of 12.0 years, 6051 (1.4%) participants occurred new-onset OSA. Overall, there was an inverse relation of serum 25(OH)D concentrations with the risk of new-onset OSA (per SD increment, HR, 0.92; 95%CI: 0.89-0.95). In the analysis of the interactions of serum 25(OH)D with the combination of BMI (<25, 25- < 30, and ≥30 kg/m) and waist circumference (WC) (<90 and ≥90 cm) categories on new-onset OSA, the significantly inverse association of serum 25(OH)D and new-onset OSA was mainly found in participants with both BMI ≥ 25 kg/m and WC ≥ 90 cm (BMI 25-30 kg/m and WC ≥ 90 cm: per SD increment, HR, 0.90; 95%CI: 0.84-0.95; BMI ≥ 30 kg/m and WC ≥ 90 cm: per SD increment, HR, 0.85; 95%CI: 0.81-0.88), but not in other four groups with BMI < 25 kg/m or WC < 90 cm (P -interaction = 0.004).

CONCLUSIONS

There was an inverse relation of serum 25(OH)D with the risk of new-onset OSA in participants with both BMI ≥ 25 kg/m and WC ≥ 90 cm. Our findings suggest the importance of maintaining a higher serum 25(OH)D concentration for primary prevention of OSA in a population with obesity.

摘要

目的

维生素 D 与阻塞性睡眠呼吸暂停(OSA)之间的前瞻性关联尚不确定。本研究旨在评估血清 25-羟维生素 D(25(OH)D)——维生素 D 的主要循环形式与新发 OSA 之间的关系,并探讨肥胖的修饰作用。

材料和方法

这项前瞻性队列研究纳入了来自英国生物库的 444975 名无 OSA 既往史的参与者。主要结局为新发 OSA。

结果

在中位随访 12.0 年期间,6051 名(1.4%)参与者发生新发 OSA。总体而言,血清 25(OH)D 浓度与新发 OSA 的风险呈负相关(每 SD 增加,HR 为 0.92;95%CI:0.89-0.95)。在分析血清 25(OH)D 与 BMI(<25、25-<30 和≥30kg/m)和腰围(WC)(<90 和≥90cm)类别组合之间的相互作用时,血清 25(OH)D 与新发 OSA 之间的显著负相关主要见于 BMI≥25kg/m 和 WC≥90cm 的参与者(BMI 25-30kg/m 和 WC≥90cm:每 SD 增加,HR 为 0.90;95%CI:0.84-0.95;BMI≥30kg/m 和 WC≥90cm:每 SD 增加,HR 为 0.85;95%CI:0.81-0.88),而在其他四个 BMI<25kg/m 或 WC<90cm 的组中未见这种相关性(P-交互=0.004)。

结论

在 BMI≥25kg/m 和 WC≥90cm 的参与者中,血清 25(OH)D 与新发 OSA 的风险呈负相关。我们的研究结果表明,在肥胖人群中,保持较高的血清 25(OH)D 浓度对于 OSA 的一级预防具有重要意义。

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