Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Hypertension Institute; NHC Key Laboratory of Hypertension Clinical Research; Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory"; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Address: No. 91 Tianchi Road, Urumqi, 830001, Xinjiang, China.
Sci Rep. 2024 Sep 6;14(1):20876. doi: 10.1038/s41598-024-71883-5.
The association between obstructive sleep apnea (OSA) and proteinuria is undetermined, with few studies on hypertension, a high-risk group for renal impairment. Therefore, we aimed to explore whether OSA is an independent risk factor for proteinuria in patients with hypertension. We investigated the cross-sectional association between OSA and proteinuria. Participants were divided into groups by apnea hypopnea index (AHI) category. Multivariable Logistic regression analysis was used to evaluate the association between OSA severity, objectively measured sleep dimensions, and proteinuria which is mainly defined by 24-h urine protein quantification > 300 mg/24 h. Sensitivity analyses were performed by excluding those with comorbidities (primary aldosteronism and homocysteine ≥ 15 μmol/L). Of the 2106 participants, the mean age was 47.57 ± 10.50 years, 67.2% were men, and 75.9% were OSA patients. In total participants, compared with those without OSA, patients with mild OSA, moderate OSA, and severe OSA showed 1.09 (95% CI 0.80-1.40), 1.24 (95% CI 0.89-1.74) and 1.47 (95% CI 1.04-2.08) fold risk for proteinuria with a trend test P trend < 0.05. Each 10-unit increase in the AHI, oxygen desaturation index (ODI), and time spent with oxygen saturation < 90% (T90) was found to be associated with 13%, 10%, and 2% higher likelihood of proteinuria in the crude model, significant in adjusted models. The more severe the OSA is, the higher the risk of proteinuria. AHI and T90 are independently associated with a higher risk of structural renal damage in the population with hypertension.
阻塞性睡眠呼吸暂停（OSA）与蛋白尿之间的关系尚不确定，而针对高血压这一肾功能损害高危人群的研究较少。因此，我们旨在探讨 OSA 是否是高血压患者蛋白尿的独立危险因素。我们研究了 OSA 与蛋白尿之间的横断面关联。根据呼吸暂停低通气指数（AHI）类别将参与者分为不同组别。采用多变量 Logistic 回归分析评估 OSA 严重程度、客观测量的睡眠维度与蛋白尿之间的关系，蛋白尿主要通过 24 小时尿蛋白定量>300mg/24h 来定义。通过排除合并症（原发性醛固酮增多症和同型半胱氨酸≥15μmol/L）进行敏感性分析。在 2106 名参与者中，平均年龄为 47.57±10.50 岁，67.2%为男性，75.9%为 OSA 患者。在所有参与者中，与无 OSA 者相比，轻度 OSA、中度 OSA 和重度 OSA 患者发生蛋白尿的风险分别为 1.09（95%CI 0.80-1.40）、1.24（95%CI 0.89-1.74）和 1.47（95%CI 1.04-2.08），趋势检验 P 趋势<0.05。在未调整模型中，AHI、氧减指数（ODI）和 T90 每增加 10 个单位，蛋白尿的可能性分别增加 13%、10%和 2%；在调整模型中，结果具有统计学意义。OSA 越严重，蛋白尿的风险越高。AHI 和 T90 与高血压人群结构性肾损伤的风险增加独立相关。
