Pataka A, Pepin J L, Bonsignore M R, Schiza S, Saaresranta T, Bouloukaki I, Steiropoulos P, Trakada G, Riha R, Dogas Z, Testelmans D, Basoglu O K, Mihaicuta S, Fanfulla F, Grote L, Bailly S
Respiratory Failure Unit G Papanikolaou Hospital Thessaloniki, Aristotle University of Thessaloniki, Greece.
Grenoble Alpes University, HP2 Laboratory, INSERM U1300and Grenoble Alpes University Hospital, Grenoble, France.
Sleep Med. 2024 Dec;124:494-501. doi: 10.1016/j.sleep.2024.10.015. Epub 2024 Oct 15.
and Objectives: The clinical presentation of Obstructive Sleep Apnoea (OSA) differs between genders. This study aimed to identify the specific OSA phenotypes of women in the European Sleep Apnoea Database (ESADA) cohort.
Latent class cluster analysis was applied to data from 9710 female OSA patients. Variables used included age, Body Mass Index (BMI), Epworth Sleepiness Scale (ESS), comorbidities (cardiovascular, pulmonary, psychiatric, metabolic, other) and the Apnoea Hypopnea Index (AHI).
Four different clusters were found: Cluster 1"Women with ischemic heart disease" (38.3 %):middle aged (59 years [53-65]),overweight to obese (BMI 30.1 kg/m [26.9-33.5]), AHI 22.9 events/h[17.4-30], ESS 9 [5,12] with the highest prevalence of ischemic heart disease (56 %). Cluster 2"Elderly women with comorbidities" (23 %): oldest (66 years[60-71]), obese (BMI 36 kg/m [31.6-40.4]),AHI 46 events/h [30-60.1]),ESS 9 [6-13] with the highest prevalence of comorbidities. Cluster 3"Sleepy obese women" (16.2 %): the youngest (49 years [42-55]), sleepiest (ESS 12 [8-16]), most obese(BMI 43 kg/m[37.6-48.9]) females with severe OSA (AHI 53.3 events/h [32-80.5]). Cluster 4 "Women with mild OSA and low comorbidities" (22.5 %): middle aged (53.5 years [46-60]) with BMI 29 kg/m[25-34.1],ESS9 [5,13]),AHI 8.6events/h[6.9-10.4])and low prevalence of comorbidities. The distribution of the clusters differed across Europe. PAP administration was higher in Clusters 2 and 3 but low in Cluster 4.
Four distinct female phenotypes were identified with different clinical presentation and comorbidities. Sex-based phenotyping may provide improved risk stratification and personalized treatment.
和目标：阻塞性睡眠呼吸暂停（OSA）的临床表现存在性别差异。本研究旨在确定欧洲睡眠呼吸暂停数据库（ESADA）队列中女性的特定OSA表型。
对9710例女性OSA患者的数据进行潜在类别聚类分析。使用的变量包括年龄、体重指数（BMI）、爱泼华嗜睡量表（ESS）、合并症（心血管、肺部、精神、代谢、其他）和呼吸暂停低通气指数（AHI）。
发现了四个不同的聚类：聚类1“患有缺血性心脏病的女性”（38.3%）：中年（59岁[53 - 65岁]），超重至肥胖（BMI 30.1kg/m[26.9 - 33.5]），AHI为22.9次事件/小时[17.4 - 30]，ESS为9[5,12]，缺血性心脏病患病率最高（56%）。聚类2“患有合并症的老年女性”（23%）：年龄最大（66岁[60 - 71岁]），肥胖（BMI 36kg/m[31.6 - 40.4]），AHI为46次事件/小时[30 - 60.1]），ESS为9[6 - 13]，合并症患病率最高。聚类3“嗜睡肥胖女性”（16.2%）：最年轻（49岁[42 - 55岁]），最嗜睡（ESS为12[8 - 16]），最肥胖（BMI 43kg/m[37.6 - 48.9]）的重度OSA女性（AHI为53.3次事件/小时[32 - 80.5]）。聚类4“轻度OSA且合并症少的女性”（22.5%）：中年（53.5岁[46 - 60岁]），BMI为29kg/m[25 - 34.1]，ESS为9[5,13]），AHI为8.6次事件/小时[6.9 - 10.4]），合并症患病率低。这些聚类在欧洲各地的分布有所不同。聚类2和3中持续气道正压通气（PAP）治疗的使用率较高，但聚类4中较低。
确定了四种不同的女性表型，具有不同的临床表现和合并症。基于性别的表型分析可能会改善风险分层和个性化治疗。
