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通过弗明汉风险评分对阻塞性睡眠呼吸暂停高风险和低风险的商用机动车驾驶员进行十年心血管风险评估。

Ten-Year Cardiovascular Risk Estimation through the Framingham Risk Score among Commercial Motor Vehicle Drivers with High and Low Risk of Obstructive Sleep Apnea.

作者信息

Sharifi Navid, Najafi Arezu, Alemohammad Zahra Banafsheh, Sadeghniiat-Haghighi Khosro

机构信息

Occupational Sleep Research Center, Baharloo Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Department of Occupational Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Sleep Sci. 2024 May 15;18(1):e1-e9. doi: 10.1055/s-0044-1782528. eCollection 2025 Mar.

Abstract

Obstructive sleep apnea (OSA) and cardiovascular disease (CVD) are both major medical causes of road accidents among commercial motor vehicle (CMV) drivers. The present study aimed to determine the association of the ten-year risk of developing CVD and other cardiac risk factors with the risk of developing OSA among apparently healthy CMV drivers.  The present cross-sectional study was conducted on 315 male CMV drivers. Demographic characteristics were collected, and the Epworth Sleepiness Scale (ESS), the Snoring, Tiredness, Observed Apnea, High Blood Pressure, Body Mass Index (BMI) > 35 kg/m , Age > 50 Years, Neck Circumference > 40 cm, and Male Gender (STOP-Bang) questionnaire, and International Physical Activity Questionnaire-Short Form (IPAQ-SF) were filled out, and the ten-year CVD risk was calculated through the Framingham Risk Score (FRS) for each individual. Laboratory tests also were performed. The participants were divided into two groups based on the STOP-Bang score and FRS, and other CVD risk factors were compared, accordingly. The Chi-squared test, the Student -test, analysis of variance (ANOVA), and logistic regression were used for the analysis.  The mean age of the drivers was of 45.57 (range: 30 to 70) years. In the univariate analysis, the mean age, years of driving experience, FRS, vascular age, blood pressure, diabetes mellitus, metabolic syndrome, ESS score, BMI, and circumference of the waist and hip presented a significant association with STOP-Bang score ≥ 3 (  < 0.05). The metabolic equivalents of task (METs) for total physical activity and walking (min/week), time spent sitting (h/day), lipid profiles, smoking history, vehicle type, and shift type were statistically similar in both groups. In the multivariate analysis, a high risk of OSA was independently associated with higher FRS (odds ratio: 1.92;  < 0.001).  The STOP-Bang score presented a direct correlation with the estimated ten-year CVD risk in CMV drivers. The high risk of developing OSA among CMV drivers is accompanied by higher CVD risk factors such as old age, diabetes, hypertension, BMI, and waist and hip circumference. The FRS was statistically higher in CMV drivers with high OSA risk.

摘要

阻塞性睡眠呼吸暂停(OSA)和心血管疾病(CVD)都是商用机动车(CMV)驾驶员发生道路交通事故的主要医学原因。本研究旨在确定表面健康的CMV驾驶员发生CVD的十年风险及其他心脏危险因素与发生OSA风险之间的关联。

本横断面研究对315名男性CMV驾驶员进行。收集了人口统计学特征,并填写了爱泼华嗜睡量表(ESS)、打鼾、疲劳、观察到的呼吸暂停、高血压、体重指数(BMI)>35kg/m²、年龄>50岁、颈围>40cm以及男性性别(STOP-Bang)问卷和国际体力活动问卷简表(IPAQ-SF),并通过弗雷明汉风险评分(FRS)为每个个体计算十年CVD风险。还进行了实验室检查。根据STOP-Bang评分和FRS将参与者分为两组,并相应比较其他CVD危险因素。采用卡方检验、学生t检验、方差分析(ANOVA)和逻辑回归进行分析。

驾驶员的平均年龄为45.57岁(范围:30至70岁)。在单因素分析中,平均年龄、驾驶年限、FRS、血管年龄、血压、糖尿病、代谢综合征、ESS评分、BMI以及腰围和臀围与STOP-Bang评分≥3呈显著关联(P<0.05)。两组的总体力活动和步行代谢当量(METs)(分钟/周)、久坐时间(小时/天)、血脂谱、吸烟史、车辆类型和班次类型在统计学上相似。在多因素分析中,OSA高风险与较高的FRS独立相关(比值比:1.92;P<0.001)。

STOP-Bang评分与CMV驾驶员估计的十年CVD风险呈正相关。CMV驾驶员发生OSA的高风险伴随着较高的CVD危险因素,如老年、糖尿病、高血压、BMI以及腰围和臀围。OSA风险高的CMV驾驶员的FRS在统计学上更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb64/12020569/3318423a2be6/10-1055-s-0044-1782528-i830-1.jpg

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