体质量指数与老年阻塞性睡眠呼吸暂停低通气综合征严重程度的相关性

目的探讨体质量指数(BMI)与老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)严重程度的相关性。方法回顾性分析2015年1月至2017年10月在解放军总医院、北京大学国际医院和甘肃中医药大学附属医院经标准多导睡眠监测诊断为OSAHS的609例老年患者(≥60岁)的病例资料。按BMI水平将研究对象分为体重正常组(n=154)、超重组(n=228)和肥胖组(n=227),比较组间多导睡眠监测指标的差异。采用SPSS 25.0软件进行数据分析。采用Spearman秩相关分析BMI与多导睡眠监测主要指标的相关性,采用多因素logistic回归分析不同BMI水平与重度OSAHS的相关性。结果3组患者呼吸暂停低通气指数(AHI)、血氧饱和度(SaO2)<90%的时间、氧减指数(ODI)、平均暂停时间、最低氧饱和度、平均氧饱和度与SaO2<90%的时间占总监测时间比例(T90)比较,差异均有统计学意义(均P<0.05);老年OSAHS患者的BMI与AHI、最长暂停时间、ODI、T90、SaO2<90%的时间呈正相关(r=0.294、0.113、0.313、0.413、0.411,均P<0.05),与平均氧饱和度、最低氧饱和度呈负相关(r=-0.173、-0.229,均P<0.05);超重组罹患重度OSAHS的风险是正常体重组的1.690倍(OR=1.690),肥胖组罹患重度OSAHS的风险更高(OR=3.685)。分层分析(高血压和无高血压)发现,肥胖与重度OSAHS的相关性在高血压和非高血压人群中均存在,但在非高血压人群中,肥胖与重度OSAHS的相关性更强。结论老年人BMI越大,OSAHS病情越严重。非高血压人群中BMI和老年OSAHS的严重程度相关性更强。

Correlation between body mass index and severity of obstructive sleep apnea hypopnea syndrome in the elderly

Objective To investigate the correlation of body mass index(BMI)with the severity of obstructive sleep apnea hypopnea syndrome(OSAHS)in the elderly.Methods The medical records of 609 elderly patients(≥60 years old)suffering from OSAHS diagnosed by standard polysomnography in Chinese PLA General Hospital,Peking University International Hospital and the Affiliated Hospital of Gansu University of Traditional Chinese Medicine from January 2015 to October 2017 were collected and analyzed retrospectively.The subjects were divided into the normal weight(n=154),overweight(n=228)and obese(n=227)groups according to their different levels of BMI.The main indicators of polysomnography were compared among the three groups.SPSS statistics 25.0 was used for data analysis.Spearman rank correlation analysis was used to study the correlation between BMI and these main indicators,and multivariate logistic regression analysis was applied to explore the correlation between different BMI levels and OSAHS severity in the elderly.Results There were no significant differences in levels of apnea hypopnea index(AHI),time of oxygen saturation(SaO2)<90%,oxygen desaturation index(ODI),mean pause time,lowest oxygen saturation,mean oxygen saturation and percentage of the times for SaO2<90%in total monitoring time during overnight sleep(T90)among the 3 groups(P<0.05).BMI was positively correlated with AHI,maximum pause time,ODI,T90 and time of SpO2<90%(r=0.294,0.113,0.313,0.413,0.411,all P<0.05),but negatively correlated with mean oxygen saturation and minimum oxygen saturation in the elderly OSAHS patients(r=-0.173,-0.229,all P<0.05).The risk of severe OSAHS in the overweight group was 1.690 times higher than that of the normal weight group(OR=1.690),and the risk was even higher in the obese group(OR=3.685).A stratified analysis between the hypertension and non-hypertension subjects found that the correlation between obesity and severe OSAHS existed in both hypertensive and non-hypertensive subgroups,and the correlation between obesity and severe OSAHS was greater in non-hypertensive subjects.Conclusion In the elderly,the greater BMI is,the more severe OSAHS is.The correlation between BMI and severity of OSAHS is stronger for the non-hypertensive elderly people.