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心脏代谢指数在筛查伴或不伴代谢综合征的阻塞性睡眠呼吸暂停中的应用价值

Application Value of Cardiometabolic Index for the Screening of Obstructive Sleep Apnea with or Without Metabolic Syndrome.

作者信息

Wang Donghao, Chen Yating, Ding Yutong, Tang Yongkang, Su Xiaofen, Li Shiwei, Zhang Haojie, Zhou Yanyan, Zhuang Zhiyang, Gan Qiming, Wang Jingcun, Zhang Yuting, Zhao Dongxing, Zhang Nuofu

机构信息

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People's Republic of China.

The Clinical Medicine Department, Henan University, Zhengzhou, People's Republic of China.

出版信息

Nat Sci Sleep. 2024 Feb 19;16:177-191. doi: 10.2147/NSS.S449862. eCollection 2024.

Abstract

BACKGROUND

Obstructive sleep apnea (OSA) is a common chronic disease with various comorbidities. The cardiometabolic index (CMI) reflects visceral fat tissue distribution and function, assessing the risk of obesity-related conditions such as metabolic syndrome (MetS) and stroke, which are strongly connected to OSA. The relationship between CMI with OSA and OSA combined with MetS (OMS) remains unclear. This study aims to evaluate the screening value of CMI for OSA and OMS, compared to the lipid accumulation product (LAP).

METHODS

A total of 280 participants who underwent polysomnography were finally included, with the measurements of metabolic-related laboratory test results such as total cholesterol and triglyceride. Receiver operating curve (ROC) analysis and calculation of the area under the curve (AUC) were conducted to assess the screening potential of CMI, LAP, and the logistic regression models established based on them for OSA and OMS. The Youden index, sensitivity, and specificity were used to determine the optimal cutoff points.

RESULTS

ROC curve analysis revealed that the AUCs for CMI in screening OSA and OMS were 0.808 and 0.797, and the optimal cutoff values were 0.71 (sensitivity 0.797, specificity 0.776) and 0.89 (sensitivity 0.830, specificity 0.662), respectively, showing higher Youden index than LAP. The AUCs of screening models based on CMI for OSA and OMS were 0.887 and 0.824, respectively.

CONCLUSION

CMI and LAP can effectively screen for OSA and OMS, while CMI has more practical cutoff values for identifying the diseased states. Screening models based on CMI demonstrate a high discriminatory ability for OSA and OMS, which needs verification in a large-scale population.

摘要

背景

阻塞性睡眠呼吸暂停(OSA)是一种常见的慢性病,伴有多种合并症。心脏代谢指数(CMI)反映内脏脂肪组织的分布和功能,评估肥胖相关疾病如代谢综合征(MetS)和中风的风险,这些疾病与OSA密切相关。CMI与OSA以及OSA合并MetS(OMS)之间的关系仍不清楚。本研究旨在评估CMI相对于脂质蓄积产物(LAP)对OSA和OMS的筛查价值。

方法

最终纳入280名接受多导睡眠图检查的参与者,测量总胆固醇和甘油三酯等代谢相关实验室检查结果。进行受试者工作特征曲线(ROC)分析并计算曲线下面积(AUC),以评估CMI、LAP以及基于它们建立的逻辑回归模型对OSA和OMS的筛查潜力。采用约登指数、敏感性和特异性来确定最佳截断点。

结果

ROC曲线分析显示,CMI筛查OSA和OMS的AUC分别为0.808和0.797,最佳截断值分别为0.71(敏感性0.797,特异性0.776)和0.89(敏感性0.830,特异性0.662),约登指数高于LAP。基于CMI的OSA和OMS筛查模型的AUC分别为0.887和0.824。

结论

CMI和LAP均可有效筛查OSA和OMS,而CMI在识别疾病状态方面具有更实用的截断值。基于CMI的筛查模型对OSA和OMS具有较高的鉴别能力,这需要在大规模人群中进行验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1ee/10887934/ff40c5fa030e/NSS-16-177-g0001.jpg

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