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血尿素氮与肌酐比值和阻塞性睡眠呼吸暂停之间的非线性关联:一项来自美国国家健康与营养检查调查(NHANES)的横断面研究

Nonlinear association between blood urea nitrogen to creatinine ratio and obstructive sleep apnea: a cross-sectional study from NHANES.

作者信息

Yang Lei, Li Lanying, Zeng TingTing, Li Yang, Li Yating, Jiang DePeng, Yue Hongmei

机构信息

Department of Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou, China.

Department of Respiratory Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

BMC Pulm Med. 2025 Mar 13;25(1):112. doi: 10.1186/s12890-025-03557-5.

Abstract

BACKGROUND

Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder that is closely associated with metabolic conditions. The Blood Urea Nitrogen to Creatinine Ratio(BUCR) is commonly utilized as a tool for evaluating renal function, particularly in cases where there are concerns about pre-renal or renal causes of azotemia. However, the connection between OSA and BUCR is not yet fully understood.

METHODS

This study examined the link between BUCR and OSA in adults over 20 using National Health and Nutrition Examination Surveys(NHANES) data from 2005-2008. Logistic regression models adjusted for multiple variables were used to analyze the relationship. The non-direct correspondence relationship were explored with a smooth curve and a two-part linear regression model, which revealed a threshold effect. Subgroup analyses were conducted to assess variations among different populations.

RESULTS

The survey, encompassing a total of 8826 participants, revealed that the median age of all respondents was 48 years, with a notable OSA prevalence of 51.3%. Upon adjusting for pertinent covariates using Model III(age, sex, marital status, education level, BMI, smoking status, drinking, hypertension, and diabetes), our findings indicated a significant association between OSA and BUCR, as evidenced by an odds ratio (OR) of 1.01 (95% CI: 1.00-1.02, P = 0.005). Furthermore, the risk association was found to be non-linear, featuring an inflection point for BUNR at 10.86. This non-linear relationship adds complexity to our understanding of the interplay between OSA and BUCR. In addition, a subgroup analysis underscored the influence of diabetes on the association between BUCR and OSA.

CONCLUSION

This study reveals a significant correlation between elevated BUCR levels and the incidence of OSA, particularly in the presence of diabetes. This discovery underscores the necessity for additional research to investigate the underlying mechanisms and ramifications of this connection within the diabetic context.

摘要

背景

阻塞性睡眠呼吸暂停(OSA)是一种常见的与睡眠相关的呼吸障碍,与代谢状况密切相关。血尿素氮与肌酐比值(BUCR)通常被用作评估肾功能的工具,特别是在担心氮质血症的肾前性或肾性原因的情况下。然而,OSA与BUCR之间的联系尚未完全明确。

方法

本研究利用2005 - 2008年美国国家健康与营养检查调查(NHANES)数据,研究了20岁以上成年人中BUCR与OSA之间的联系。使用针对多个变量进行调整的逻辑回归模型来分析这种关系。通过平滑曲线和两部分线性回归模型探索了非直接对应关系,揭示了一种阈值效应。进行亚组分析以评估不同人群之间的差异。

结果

该调查共纳入8826名参与者,所有受访者的中位年龄为48岁,OSA患病率高达51.3%。使用模型III(年龄、性别、婚姻状况、教育水平、BMI、吸烟状况、饮酒、高血压和糖尿病)对相关协变量进行调整后,我们的研究结果表明OSA与BUCR之间存在显著关联,优势比(OR)为1.01(95% CI:1.00 - 1.02,P = 0.005)。此外,发现风险关联是非线性的,BUNR的拐点为10.86。这种非线性关系增加了我们对OSA与BUCR之间相互作用的理解的复杂性。此外,亚组分析强调了糖尿病对BUCR与OSA之间关联的影响。

结论

本研究揭示了BUCR水平升高与OSA发病率之间存在显著相关性,尤其是在糖尿病患者中。这一发现强调了有必要进行更多研究,以调查糖尿病背景下这种关联的潜在机制和影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b656/11905582/b2c2015eaffc/12890_2025_3557_Fig1_HTML.jpg

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