Azegami Tatsuhiko, Kaneko Hidehiro, Okada Akira, Suzuki Yuta, Ko Toshiyuki, Fujiu Katsuhito, Takeda Norifumi, Morita Hiroyuki, Takeda Norihiko, Yokoo Takashi, Yasunaga Hideo, Nangaku Masaomi, Hayashi Kaori
Division of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Department of Cardiovascular Medicine, University of Tokyo, Tokyo, Japan.
Sleep. 2025 Mar 11;48(3). doi: 10.1093/sleep/zsae302.
Sleep apnea syndrome (SAS) is potentially linked to life-threatening conditions. The decline in kidney function is involved in the development of various diseases; however, it remains unclear whether it is implicated in the onset of SAS. Therefore, this study aimed to investigate the relationship between kidney function and the incidence of SAS.
The association of estimated glomerular filtration rate (eGFR) with the incidence of SAS was assessed retrospectively using real-world administrative claims and health checkup data collected between April 2014 and November 2022. To strengthen robustness, three stratified analyses and four sensitivity analyses were conducted.
We assessed 1 589 259 individuals for the analysis. During a median (interquartile range) follow-up of 1167 (652-1699) days, 11 054 cases of SAS events were documented. Multivariable Cox regression analyses after adjusting for potential confounders, including age, sex, body mass index, hypertension, diabetes, dyslipidemia, cigarette smoking, alcohol drinking, and physical inactivity, demonstrated that the decrease in eGFR (eGFR ≥ 90, 60-89, 45-59, 30-44, and <30 mL/min/1.73 m2) was associated with a higher risk of SAS (hazard ratio [95% confidence intervals]; 1 [reference value], 1.13 [1.06-1.20], 1.22 [1.13-1.32], 1.34 [1.17-1.52], 1.82 [1.43-2.33]). In the restricted cubic spline regression model, the risk of developing SAS increased with the reduction in eGFR. The results of the sensitivity analyses were consistent with the primary findings.
Our analysis utilizing a large-scale population-based cohort concluded that reduced eGFR is associated with the risk of developing SAS in a dose-dependent manner.
睡眠呼吸暂停综合征（SAS）可能与危及生命的状况相关。肾功能下降与多种疾病的发生有关；然而，肾功能下降是否与SAS的发病有关仍不清楚。因此，本研究旨在探讨肾功能与SAS发病率之间的关系。
使用2014年4月至2022年11月期间收集的真实世界行政索赔和健康检查数据，回顾性评估估计肾小球滤过率（eGFR）与SAS发病率之间的关联。为增强稳健性，进行了三项分层分析和四项敏感性分析。
我们评估了1589259名个体进行分析。在中位（四分位间距）1167（652 - 1699）天的随访期间，记录了11054例SAS事件。在调整了包括年龄、性别、体重指数、高血压、糖尿病、血脂异常、吸烟、饮酒和身体活动不足等潜在混杂因素后的多变量Cox回归分析表明，eGFR下降（eGFR≥90、60 - 89、45 - 59、30 - 44和<30 mL/min/1.73 m²）与SAS风险较高相关（风险比[95%置信区间]；1[参考值]，1.13[1.06 - 1.20]，1.22[1.13 - 1.32]，1.34[1.17 - 1.52]，1.82[1.43 - 2.33]）。在受限立方样条回归模型中，发生SAS的风险随着eGFR的降低而增加。敏感性分析结果与主要发现一致。
我们利用大规模人群队列的分析得出结论，eGFR降低与发生SAS的风险呈剂量依赖性相关。
