Wang Liang, Shen Ying-Ying, Qian Rui-Qi, Zhang Xiu-Qin, Shen Xu-Rui, Chen Cheng
Department of Emergency Medicine, the First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
Department of Critical Care Medicine, Linyi People's Hospital, Linyi, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2025 Jun 10;20:1843-1849. doi: 10.2147/COPD.S514400. eCollection 2025.
Overlap Syndrome (OVS), combining Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea (OSA), is common yet often unrecognized. This study aims to compare the Fat - Free Mass Index (FFMI) between OVS and simple COPD patients and analyze subgroup differences in OVS for better early identification and severity assessment.
Clinical data of 364 patients (203 in COPD group, 161 in OVS group) were analyzed regarding clinical features, pulmonary function, sleep apnea, etc. The OVS group was divided into low-FFMI and normal-FFMI subgroups (the cutoff value of FFMI < 17kg/m²) for correlation analysis.
Statistically significant differences in frequency of acute exacerbations and hospitalizations in the past year, and comorbidities were observed between the COPD group and OVS group (all p < 0.05). The OVS group exhibited significantly lower FEV%pred, FEV /FVC, 6MWT, FFMI, and L-SaO compared to the COPD group (all p < 0.05), while AHI, ESS, CAT, and MMRC were higher. Patients with lower FFMI demonstrated lower FEV%pred, FEV/FVC, L-SaO2, and 6MWT than those with normal FFMI. Additionally, AHI, MMRC, frequency of acute exacerbations, and hospitalizations in the past year were higher (all p < 0.05) in this group. Correlation analysis revealed that in the OVS group, FFMI positively correlated with FEV1%pred and FEV1/FVC, and negatively with AHI, MMRC, exacerbation/hospitalization frequency.
OVS patients had distinct features like more exacerbations, and lower lung function. The OVS subgroup with different FFMI showed significant differences in lung function and sleep indices. FFMI is closely related to pulmonary function, sleep disorder indices, and exacerbation frequency, suggesting its potential as an important indicator for early OVS identification and severity evaluation despite no significant difference in BMI.
重叠综合征（OVS），即慢性阻塞性肺疾病（COPD）与阻塞性睡眠呼吸暂停（OSA）并存，较为常见但常未被识别。本研究旨在比较OVS患者与单纯COPD患者的去脂体重指数（FFMI），并分析OVS患者的亚组差异，以实现更好的早期识别和严重程度评估。
分析364例患者（COPD组203例，OVS组161例）的临床资料，包括临床特征、肺功能、睡眠呼吸暂停等。将OVS组分为低FFMI亚组和正常FFMI亚组（FFMI临界值<17kg/m²）进行相关性分析。
COPD组与OVS组在过去一年的急性加重频率、住院次数及合并症方面存在统计学显著差异（均p<0.05）。与COPD组相比，OVS组的FEV%pred、FEV/FVC、6分钟步行试验（6MWT）、FFMI及最低血氧饱和度（L-SaO）显著更低（均p<0.05），而呼吸暂停低通气指数（AHI）、Epworth嗜睡量表（ESS）、慢性阻塞性肺疾病评估测试（CAT）及改良英国医学研究委员会呼吸困难量表（MMRC）更高。FFMI较低的患者，其FEV%pred、FEV/FVC、L-SaO₂及6MWT低于FFMI正常的患者。此外，该组患者的AHI、MMRC、过去一年的急性加重频率及住院次数更高（均p<0.05）。相关性分析显示，在OVS组中，FFMI与FEV1%pred和FEV1/FVC呈正相关，与AHI、MMRC、加重/住院频率呈负相关。
OVS患者具有急性加重更多、肺功能更低等独特特征。不同FFMI的OVS亚组在肺功能和睡眠指标方面存在显著差异。FFMI与肺功能、睡眠障碍指标及加重频率密切相关，表明尽管体重指数（BMI）无显著差异，但FFMI有潜力作为OVS早期识别和严重程度评估的重要指标。
