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血清25-羟维生素D浓度与阻塞性睡眠呼吸暂停之间存在关联吗?对2007 - 2008年美国国家健康和营养检查调查(NHANES)数据的横断面分析。

Is there an association between serum 25-hydroxyvitamin D concentrations and obstructive sleep apnoea? A cross-sectional analysis of NHANES 2007-2008 data.

作者信息

Li Qingyuan, Yao Jun, Duan Ran, Feng Tong

机构信息

Clinical Medical College, Chengdu Medical College, Chengdu, People's Republic of China.

Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Chengdu Medical College, Chengdu, People's Republic of China.

出版信息

BMJ Open. 2024 Aug 7;14(8):e085080. doi: 10.1136/bmjopen-2024-085080.

Abstract

OBJECTIVES

The study aimed to investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) concentrations and obstructive sleep apnoea (OSA) and to assess the confounding effect of body mass index (BMI) on this relationship.

DESIGN

This was a cross-sectional analysis using data from the 2007-08 National Health and Nutrition Examination Survey (NHANES).

SETTING

Data were sourced from NHANES, a continuous survey sponsored by the Centres for Disease Control and Prevention, covering residents from 15 urban areas in the United States of America(USA).

PARTICIPANTS

The study included 4901 participants aged 16 years and older who had completed 25(OH)D data and responses to the OSA questionnaire.

MAIN EXPOSURE MEASURE

Serum 25(OH)D concentrations were measured using liquid chromatography-tandem mass spectrometry.

MAIN OUTCOME MEASURE

The primary outcome was the self-reported diagnosis of OSA from questionnaires.

RESULTS

After adjusting for age, sex and race (model 1), a significant negative association was observed between 25(OH)D and OSA (β=-3.21, 95% CI: -6.17 to -0.26). However, this association was no longer significant after further adjustment for BMI (model 2) (β=1.47, 95% CI: -1.48, 4.42). In the fully adjusted model (model 3), there was no significant association between 25(OH)D and OSA (β=0.92, 95% CI: -1.93, 3.76). Subgroup analyses stratified by sex, age, race or BMI also revealed no significant associations between 25(OH)D and OSA.

CONCLUSIONS

The study found no significant association between 25(OH)D and OSA. The observed correlation between lower levels of 25(OH)D and OSA may be due to confounding factors, such as higher BMI in the OSA group. Therefore, improving obesity management in OSA patients may be necessary to prevent 25(OH)D insufficiency. This underscores the importance of comprehensive management of both OSA and obesity to promote optimal health outcomes.

摘要

目的

本研究旨在调查血清25-羟基维生素D(25(OH)D)浓度与阻塞性睡眠呼吸暂停(OSA)之间的关系,并评估体重指数(BMI)对这种关系的混杂效应。

设计

这是一项横断面分析,使用了2007 - 08年美国国家健康与营养检查调查(NHANES)的数据。

背景

数据来源于NHANES,这是一项由疾病控制与预防中心发起的持续性调查,涵盖了美国15个城市地区的居民。

参与者

该研究纳入了4901名16岁及以上的参与者,他们完成了25(OH)D数据采集以及OSA问卷回答。

主要暴露指标

采用液相色谱 - 串联质谱法测量血清25(OH)D浓度。

主要结局指标

主要结局是通过问卷进行的OSA自我报告诊断。

结果

在调整年龄、性别和种族后(模型1),观察到25(OH)D与OSA之间存在显著的负相关(β = -3.21,95%置信区间:-6.17至-0.26)。然而,在进一步调整BMI后(模型2),这种关联不再显著(β = 1.47,95%置信区间:-1.48,4.42)。在完全调整模型(模型3)中,25(OH)D与OSA之间无显著关联(β = 0.92,95%置信区间:-1.93,3.76)。按性别、年龄、种族或BMI分层的亚组分析也显示25(OH)D与OSA之间无显著关联。

结论

该研究发现25(OH)D与OSA之间无显著关联。观察到的25(OH)D水平较低与OSA之间的相关性可能归因于混杂因素,如OSA组中较高的BMI。因此,改善OSA患者的肥胖管理对于预防25(OH)D不足可能是必要的。这强调了对OSA和肥胖进行综合管理以促进最佳健康结局的重要性。

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