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阻塞性睡眠呼吸暂停成人患者维生素D状态与多导睡眠图参数之间的关联

Associations between Vitamin D Status and Polysomnographic Parameters in Adults with Obstructive Sleep Apnea.

作者信息

Kechribari Ioanna, Kontogianni Meropi D, Georgoulis Michael, Lamprou Kallirroi, Perraki Eleni, Vagiakis Emmanouil, Yiannakouris Nikos

机构信息

Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676 Athens, Greece.

Center of Sleep Disorders, 1st Department of Critical Care, Evangelismos General Hospital, 10676 Athens, Greece.

出版信息

Life (Basel). 2024 Feb 18;14(2):275. doi: 10.3390/life14020275.

Abstract

Vitamin D deficiency (VDD) may be associated with obstructive sleep apnea (OSA) presence and is more pronounced with increasing OSA severity; however, the relationship between these two entities remains unclear. This was a cross-sectional study among 262 adults with in-hospital-attended polysomnography-diagnosed OSA and no additional major comorbidities, aiming to explore possible associations between serum 25-hydroxyvitamin D [25(OH)D] levels and polysomnographic parameters. Data on demographics, medical history, anthropometric indices, and lifestyle habits were collected at enrolment. Serum 25(OH)D was evaluated using chemiluminescence, with VDD defined as 25(OH)D < 20 ng/mL. VDD was observed in 63% of the participants. Serum 25(OH)D correlated negatively with apnea-hypopnea index and other polysomnographic indices (all < 0.05). In logistic regression analysis, adjusting for age, sex, smoking, body mass index, physical activity, dietary vitamin D intake, and season of blood sampling, serum 25(OH)D was associated with lower odds of severe OSA [odds ratio (95% confidence interval): 0.94 (0.90-0.98)]. In the same multivariate model, VDD was associated with ~threefold higher odds of severe OSA [2.75 (1.38-5.48)]. In stratified analyses, VDD predicted OSA severity in the group of participants ≥50 y [3.54 (1.29-9.68)] and among those with body mass index ≥ 30 kg/m [3.38 (1.52-7.52)], but not in the younger and non-obese adults. This study provides further evidence of an inverse association between vitamin D levels and OSA severity and underscores the importance of considering vitamin D status as a potential modifiable factor in the comprehensive management of OSA.

摘要

维生素D缺乏(VDD)可能与阻塞性睡眠呼吸暂停(OSA)的存在有关,且随着OSA严重程度的增加而更加明显;然而,这两者之间的关系仍不明确。这是一项针对262名因住院接受多导睡眠图诊断为OSA且无其他主要合并症的成年人的横断面研究,旨在探讨血清25-羟基维生素D [25(OH)D]水平与多导睡眠图参数之间可能存在的关联。在入组时收集了人口统计学、病史、人体测量指标和生活习惯等数据。采用化学发光法评估血清25(OH)D,VDD定义为25(OH)D < 20 ng/mL。63%的参与者存在VDD。血清25(OH)D与呼吸暂停低通气指数及其他多导睡眠图指标呈负相关(均P < 0.05)。在逻辑回归分析中,校正年龄、性别、吸烟、体重指数、身体活动、饮食中维生素D摄入量和采血季节后,血清25(OH)D与严重OSA的较低几率相关[比值比(95%置信区间):0.94(0.90 - 0.98)]。在同一多变量模型中,VDD与严重OSA的几率高约三倍相关[2.75(1.38 - 5.48)]。在分层分析中,VDD在年龄≥50岁的参与者组[3.54(1.29 - 9.68)]以及体重指数≥30 kg/m²的参与者中[3.38(1.52 - 7.52)]可预测OSA严重程度,但在年轻和非肥胖成年人中则不然。本研究进一步证明了维生素D水平与OSA严重程度之间存在负相关,并强调了在OSA综合管理中考虑维生素D状态作为潜在可调节因素的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8108/10889962/308c97a779a7/life-14-00275-g001.jpg

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