Zhu Yanqiu, Jiang Qiao, Zhang Yuqing, Xie Dongxing, Yang Zidan, Lu Na, Zeng Chao, Lei Guanghua, Wei Jie, Yang Tuo
Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
Departmenf of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
Clin Rheumatol. 2025 May 7. doi: 10.1007/s10067-025-07457-1.
Osteoarthritis (OA) is the most common joint disease, leading to pain and inflammation, two risk factors for sleep apnea (SA). We aimed to examine whether OA may increase the risk of incident SA, a common source of mortality and sudden death.
Using data from the IQVIA Medical Research Database, we conducted three cohort studies (i.e., knee, hip, and hand cohort) among individuals aged 50 years or older. For each patient with incident OA, up to five non-OA individuals were matched by age, sex, entry-time, and BMI. We calculated the incidence rate of SA for the OA and non-OA cohorts, respectively, and examined the relation of OA to the risk of incident SA using a Cox proportional hazard model adjusting for potential confounders.
During the follow-up, 869 SA cases occurred in 58,674 patients with knee OA and 2,186 in 235,850 non-OA individuals (2.29 vs. 1.41/1000 person-years). Compared with the non-OA cohort, the multivariable-adjusted hazard ratio (HR) of SA in the knee OA cohort was 1.45 (95% confidence interval [CI]: 1.34-1.56). A higher risk of SA was also observed among patients with incident hip OA (adjusted HR: 1.45, 95%CI: 1.28-1.66) and hand OA (adjusted HR: 1.50, 95%CI: 1.26-1.78) than the matched non-OA individuals.
This general population-based study provides the first evidence that patients with knee, hip, and hand OA may have an increased risk of incident SA. Strategies aimed at screening, prevention, and treatment of SA could be developed to reduce the disease burden in OA patients.
骨关节炎（OA）是最常见的关节疾病，会导致疼痛和炎症，而这两者是睡眠呼吸暂停（SA）的两个风险因素。我们旨在研究OA是否会增加SA发病风险，SA是死亡和猝死的常见原因。
利用IQVIA医学研究数据库的数据，我们在50岁及以上的人群中开展了三项队列研究（即膝关节、髋关节和手部队列）。对于每例新诊断为OA的患者，按年龄、性别、入组时间和体重指数匹配多达五名非OA个体。我们分别计算了OA队列和非OA队列中SA的发病率，并使用Cox比例风险模型调整潜在混杂因素，研究OA与SA发病风险之间的关系。
随访期间，58,674例膝关节OA患者中有869例发生SA，235,850例非OA个体中有2,186例发生SA（发病率分别为2.29/1000人年和1.41/1000人年）。与非OA队列相比，膝关节OA队列中SA的多变量调整风险比（HR）为1.45（95%置信区间[CI]：1.34-1.56）。与匹配的非OA个体相比，髋关节OA（调整后HR：1.45，95%CI：1.28-1.66）和手部OA（调整后HR：1.50，95%CI：1.26-1.78）患者发生SA的风险也更高。
这项基于普通人群的研究首次证明，膝关节、髋关节和手部OA患者发生SA的风险可能会增加。可以制定旨在筛查、预防和治疗SA的策略，以减轻OA患者的疾病负担。
