阻塞性睡眠呼吸暂停与肺功能及其与夜间低氧血症的关系：来自瑞典心肺生物影像学研究（SCAPIS）的横断面研究结果

Obstructive sleep apnoea and lung function, and their association with nocturnal hypoxemia: results from the Swedish CArdioPulmonary bioimage Study (SCAPIS) - a cross-sectional study.

机构信息

Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University Faculty of Medicine, Uppsala, Sweden

Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University Faculty of Medicine, Uppsala, Sweden.

出版信息

BMJ Open. 2024 Nov 17;14(11):e086596. doi: 10.1136/bmjopen-2024-086596.

DOI:10.1136/bmjopen-2024-086596

PMID:39551582

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11574465/

Abstract

UNLABELLED

Obstructive sleep apnoea (OSA) and its associations with lung function.

BACKGROUND

OSA is highly prevalent and characterised by abnormal respiration during sleep. This large, population-based study aimed to investigate the associations between OSA and lung function in subjects aged 50-64 years.

METHOD

The population-based Swedish CArdioPulmonary bioimage Study includes information on anthropometry, comorbidities and spirometry. The current analysis included data from three centres (Gothenburg, Umeå and Uppsala) on whole-night respiratory polygraphy as a meta-analysis examining the overall effect size of lung function on sleep apnoea severity, expressed as ß-coefficient after stratifying for sex and adjusting for age, waist circumference and smoking status.

RESULTS

Data from 9016 participants (54% women, age 58±4 years, body mass index 27±4 kg/m ) with sleep recordings of good quality were included in the final analysis. Forced expiratory volume during 1 s (FEV ) (ß=-0.10 (95% CI -0.16 to -0.03)), forced vital capacity (FVC) (-0.15 (-0.21 to -0.10)) and diffusion capacity for carbon monoxide (DL ) (-0.08 (-0.10 to -0.05)) were all negatively associated with the oxygen desaturation index (ODI) and also with per cent of registration with nocturnal oxygen saturation <90% FVC (-0.44 (-0.87 to -0.01)), FEV (-0.86 (-1.36 to -0.36)) and DL (-0.47 (-0.60 to -0.35)). Additionally, a positive association was observed between FEV (0.13 (0.05 to 0.22)) and DL (0.07 (0.04 to 0.09)) with the mean nocturnal saturation. There was a negative association between DL and apnoea-hypopnoea index, AHI, (ß=-0.04 (95% CI-0.06 to -0.03)), while no associations were found between FEV or FVC and AHI.

CONCLUSION

In OSA, lower lung function is more distinctly associated with the nocturnal hypoxic burden than AHI. Potential lung function impairment should be investigated in OSA patients with a high ODI relative to AHI.

摘要

目的

阻塞性睡眠呼吸暂停（OSA）及其与肺功能的关系。

背景

OSA 患病率高，其特征为睡眠期间呼吸异常。这项基于人群的大型研究旨在调查 50-64 岁人群中 OSA 与肺功能之间的关系。

方法

基于人群的瑞典心肺生物影像研究包括人体测量学、合并症和肺活量测定的信息。目前的分析包括来自三个中心（哥德堡、于默奥和乌普萨拉）的整个夜间呼吸多导睡眠图的数据，作为一项荟萃分析，根据性别分层，以 β 系数来检验肺功能对睡眠呼吸暂停严重程度的总体影响大小，调整年龄、腰围和吸烟状况后得出。

结果

共有 9016 名参与者（54%为女性，年龄 58±4 岁，体重指数 27±4kg/m2），睡眠记录质量良好，纳入最终分析。1 秒用力呼气容积（FEV1）（β=-0.10（95%CI-0.16 至-0.03））、用力肺活量（FVC）（β=-0.15（β=-0.21 至-0.05））和一氧化碳弥散量（β=-0.08（β=-0.10 至-0.05））均与氧减指数（ODI）呈负相关，也与夜间血氧饱和度＜90%FVC 的登记百分比呈负相关（β=-0.44（β=-0.87 至-0.01））、FEV1（β=-0.86（β=-1.36 至-0.36））和 DL（β=-0.47（β=-0.60 至-0.35））。此外，还观察到 FEV1（β=0.13（β=0.05 至 0.22））和 DL（β=0.07（β=0.04 至 0.09））与平均夜间饱和度呈正相关。DL 与呼吸暂停低通气指数（AHI）呈负相关（β=-0.04（95%CI-0.06 至-0.03）），而 FEV1 或 FVC 与 AHI 之间无相关性。