Larsen Lucas Møller, Winther Sine Voss, Kørvel-Hanquist Asbjørn, Marott Sarah C W, Landt Eskild M, Homøe Preben, Nordestgaard Børge G, Dahl Morten
Department of Clinical Biochemistry, Zealand University Hospital, 4600, Køge, Denmark.
Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Eur Arch Otorhinolaryngol. 2025 May;282(5):2679-2686. doi: 10.1007/s00405-025-09270-7. Epub 2025 Mar 14.
α-Antitrypsin deficiency is a disease characterized by increased neutrophil elastase activity leading to tissue getting less elastic and robust. It is known that if tissue in the pharynx becomes less elastic and robust, it could contribute to obstructive sleep apnea. This paper seeks to investigate whether patients with α-antitrypsin deficiency have an increased risk of sleep apnea.
We tested this hypothesis by doing a nationwide cohort study of 2702 individuals diagnosed with α-antitrypsin deficiency compared with 26,750 individuals without α-antitrypsin deficiency matched on sex, age, and municipality. All individuals were followed from birth and were censored at the time of outcome, emigration, death, or end of follow-up 31st of December 2018, whichever came first.
Individuals with α-antitrypsin deficiency had a higher risk of sleep apnea with an adjusted hazard ratio of 1.81 (95% CI 1.36-2.40) compared to controls without α-antitrypsin deficiency. Similarly, the risk of obstructive sleep apnea was nominally higher in individuals with α-antitrypsin deficiency compared to controls without the disease (1.47, 95% CI 0.95-2.28). In stratified analysis, the risk of sleep apnea was higher in individuals without chronic obstructive pulmonary disease (2.33, 95% CI 1.54-3.51) (P for interaction < 0.05). The increased risk of SA was unaffected when the analysis was stratified by ischemic heart disease, ischemic cerebrovascular disease, type 2 diabetes, hypertension, and liver cirrhosis.
Individuals with α-antitrypsin deficiency have a higher risk of sleep apnea in the Danish population.
α-抗胰蛋白酶缺乏症是一种以中性粒细胞弹性蛋白酶活性增加为特征的疾病，可导致组织弹性和韧性降低。已知如果咽部组织的弹性和韧性降低，可能会导致阻塞性睡眠呼吸暂停。本文旨在研究α-抗胰蛋白酶缺乏症患者患睡眠呼吸暂停的风险是否增加。
我们通过对2702名被诊断为α-抗胰蛋白酶缺乏症的个体进行全国性队列研究来验证这一假设，并与26750名在性别、年龄和城市方面匹配的无α-抗胰蛋白酶缺乏症的个体进行比较。所有个体从出生开始随访，在出现结局、移民、死亡或2018年12月31日随访结束时（以先发生者为准）进行截尾。
与无α-抗胰蛋白酶缺乏症的对照组相比，α-抗胰蛋白酶缺乏症患者患睡眠呼吸暂停的风险更高，调整后的风险比为1.81（95%可信区间1.36 - 2.40）。同样，与无该疾病的对照组相比，α-抗胰蛋白酶缺乏症患者患阻塞性睡眠呼吸暂停的风险名义上更高（1.47，95%可信区间0.95 - 2.28）。在分层分析中，无慢性阻塞性肺疾病的个体患睡眠呼吸暂停的风险更高（2.33，95%可信区间1.54 - 3.51）（交互作用P<0.05）。当按缺血性心脏病、缺血性脑血管病、2型糖尿病、高血压和肝硬化进行分层分析时，睡眠呼吸暂停风险增加不受影响。
在丹麦人群中，α-抗胰蛋白酶缺乏症患者患睡眠呼吸暂停的风险更高。
