Ong K C, Clerk A A
Stanford University Sleep Disorders Clinic and Research Center, Stanford University School of Medicine, CA, USA.
Respir Med. 1998 Jun;92(6):843-8. doi: 10.1016/s0954-6111(98)90386-9.
Race can be considered a risk factor for sleep-disordered breathing (SDB), with higher prevalences and greater severity of the disorder documented among persons of certain racial groups compared with others. Based on clinical observation, it was hypothesized that, other risk factors being equal, Asian patients with SDB have greater severity of their illness compared to Caucasian patients. A cross-sectional study was conducted at a sleep disorders clinic involving 105 Asian patients diagnosed as having SDB after undergoing polysomnography and 99 similarly diagnosed Caucasian patients matched for the following variables: age, gender and body mass index (BMI). The main outcome measure of interest was objective assessment of severity based on polysomnographic data of respiratory disturbance index (RDI) and minimum oxygen saturation (SaO2) during sleep. Symptom scores between patients of the two racial groups were also compared. There were significantly larger proportions of Asians compared to Caucasians with severe obstructive sleep apnea (OSAS) as defined by respiratory disturbance index (RDI) > or = 50 (25.0% vs 11.1%; P = 0.0288) or minimum oxygen saturation (SaO2) < or = 69% (20.6% vs 4.2%; P = 0.0113). The mean minimum SaO2 was significantly lower (P = 0.0001) while the mean (log transformed) esophageal pressure (Pes) value was significantly higher (P = 0.0090) in the Asian group. Logistic regression analysis showed that race was associated with severe SDB (RDI > or = 50) independent of age, sex and BMI. The estimated odds ratio for Asians having severe OSAS compared with Caucasians was 2.51 [95% Confidence Interval (CI) 0.98-6.64]. There was no significant difference in the severity of questionnaire-based symptoms of snoring, apneas during sleep and the median Epworth scores between Asian and Caucasian patients. Based on objective polysomnographic results, Asian patients with OSAS have greater severity of their illness compared to Caucasian patients matched for age, gender and BMI. There was, however, no significant difference in severity of questionnaire-based symptoms between Asian and Caucasian patients with SDB.
种族可被视为睡眠呼吸障碍（SDB）的一个风险因素，与其他种族群体相比，某些种族群体中该疾病的患病率更高且病情更严重。基于临床观察，有人提出假设，在其他风险因素相同的情况下，与白种人患者相比，患有SDB的亚洲患者病情更严重。在一家睡眠障碍诊所进行了一项横断面研究，纳入了105名经多导睡眠图检查确诊患有SDB的亚洲患者以及99名经类似诊断的白种人患者，这些患者在年龄、性别和体重指数（BMI）等变量上进行了匹配。主要关注的结局指标是根据睡眠期间呼吸紊乱指数（RDI）和最低血氧饱和度（SaO2）的多导睡眠图数据对病情严重程度进行客观评估。还比较了两个种族群体患者之间的症状评分。按照呼吸紊乱指数（RDI）>或=50（25.0%对11.1%；P = 0.0288）或最低血氧饱和度（SaO2）<或=69%（20.6%对4.2%；P = 0.0113）定义，与白种人相比，患有重度阻塞性睡眠呼吸暂停（OSAS）的亚洲人比例显著更高。亚洲组的平均最低SaO2显著更低（P = 0.0001），而平均（对数转换）食管压力（Pes）值显著更高（P = 0.0090）。逻辑回归分析表明，种族与重度SDB（RDI>或=50）相关，独立于年龄、性别和BMI。与白种人相比，亚洲人患有重度OSAS的估计比值比为2.51[95%置信区间（CI）0.98 - 6.64]。在基于问卷的打鼾、睡眠期间呼吸暂停症状严重程度以及亚洲和白种人患者的埃普沃思评分中位数方面，没有显著差异。基于客观的多导睡眠图结果，与年龄、性别和BMI相匹配的白种人患者相比，患有OSAS的亚洲患者病情更严重。然而，患有SDB的亚洲和白种人患者在基于问卷的症状严重程度方面没有显著差异。
