慢性阻塞性肺疾病、重度肥胖与阻塞性睡眠呼吸暂停高风险的三重重叠：来自美国国家健康与营养检查调查分析的见解

The triple overlap of COPD, severe obesity, and high risk of OSA: insights from an NHANES analysis.

作者信息

Orbell Staci L, Morris Jonna L, Scott Paul W, Baniak Lynn M, Imes Christopher C, Jeon Bomin, Wang Weiwen, Dong Yue, Strollo Patrick J, Luyster Faith S

机构信息

Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.

School of Nursing, University of Pittsburgh, 3500 Victoria St, 415 Victoria Building, Pittsburgh, PA, 15241, USA.

出版信息

BMC Pulm Med. 2025 Jun 4;25(1):282. doi: 10.1186/s12890-025-03752-4.

DOI:10.1186/s12890-025-03752-4

PMID:40468243

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12139052/

Abstract

PURPOSE

With the rising prevalence of severe obesity, the coexistence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) often progresses to triple overlap syndrome, a condition with significant health implications. However, its prevalence remains poorly understood. Using population-based data from the National Health and Nutrition Examination Survey (NHANES), we examined the prevalence of triple overlap of COPD, severe obesity, and high risk for OSA (HR-OSA) and associated sociodemographic factors among US adults.

METHODS

A cross-sectional analysis was performed using NHANES data between 2005 and 2008 and 2015-March 2020. COPD diagnosis was collected via self-report questionnaire. HR-OSA was determined by an adapted Multivariable Apnea Prediction index. Severe obesity was defined as a body mass index of ≥ 40.0 kg/m.

RESULTS

From 2005 to 2008 to 2015-March 2020, the proportion of participants with triple overlap of COPD, severe obesity, and HR-OSA increased from 0.653% (95% CI, 0.651-0.655%) to 1.560% (95% CI, 1.557-1.563%). During the same period, the increase in the age-standardized prevalence of severe obesity (from 6.298% [95% CI, 6.291-6.305%] to 8.943% [95% CI, 8.936-8.950%]) and HR-OSA (from 58.667% [95% CI, 58.646-58.688%] to 58.776% [95% CI, 58.758-58.794%]; ) exceeded the increase for COPD (from 9.223% [95% CI, 9.215-9.231%] to 10.213% [95% CI, 10.206-10.220%]). Women and those with low family income were more likely to have triple overlap of COPD, severe obesity, and HR- OSA.

CONCLUSION

The triple overlap of COPD, severe obesity, and HR-OSA significantly increased among US adults over the past 15 years, with disparities across different sociodemographic groups.

TRIAL REGISTRATION

Not applicable.

摘要

目的

随着重度肥胖患病率的上升，阻塞性睡眠呼吸暂停（OSA）与慢性阻塞性肺疾病（COPD）共存常发展为三联重叠综合征，这一情况对健康有重大影响。然而，其患病率仍知之甚少。利用美国国家健康与营养检查调查（NHANES）的基于人群的数据，我们研究了美国成年人中COPD、重度肥胖和OSA高风险（HR-OSA）三联重叠的患病率及相关社会人口学因素。

方法

使用2005年至2008年以及2015年至2020年3月期间的NHANES数据进行横断面分析。通过自我报告问卷收集COPD诊断信息。采用改良的多变量呼吸暂停预测指数确定HR-OSA。重度肥胖定义为体重指数≥40.0kg/m²。

结果

从2005年至2008年到2015年至2020年3月，COPD、重度肥胖和HR-OSA三联重叠参与者的比例从0.653%（95%CI，0.651-0.655%）增至1.560%（95%CI，1.557-1.563%）。在同一时期，重度肥胖年龄标准化患病率的增幅（从6.298%[95%CI，6.291-6.305%]至8.943%[95%CI，8.936-8.950%]）和HR-OSA的增幅（从58.667%[95%CI，58.646-58.688%]至58.776%[95%CI，58.758-58.794%]）超过了COPD的增幅（从9.223%[95%CI，9.215-9.231%]至10.213%[95%CI，10.206-10.220%]）。女性和家庭收入低的人更有可能出现COPD、重度肥胖和HR-OSA的三联重叠。