减重代谢手术患者腹部脂肪分布与阻塞性睡眠呼吸暂停的相关性研究

目的 分析腹部磁共振(MR)图像中腰1-腰2(L1-L2)层面腹腔内脏脂肪(VAT)、腹腔皮下脂肪(SAT)含量及体质量指数(BMI)与阻塞性睡眠呼吸暂停(OSA)的发生及严重程度之间的关系.方法 选取2017年11月至2019年11月于首都医科大学附属北京友谊医院治疗的代谢综合征患者的临床资料,收集BMI、多导睡眠检...

Correlation between abdominal fat distribution and obstructive sleep apnea in patients undergoing metabolic and bariatric surgery

ObjectiveAnalyze the content of visceral abdominal fat (VAT) and subcutaneous abdominal fat (SAT) at L1-L2 level in abdominal magnetic resonance (MR). Analyze the relationship between abdominal visceral fat (VAT), abdominal subcutaneous fat (SAT), body mass index (BMI) and the occurrence and severity of obstructive sleep apnea-hypopnea syndrome (OSA). MethodsThe clinical data of patients with metabolic syndrome treated in our hospital from November 2017 to November 2019 were selected, and the results of body mass index (BMI), polysomnography (PSG), and abdominal MR were collected. Analyze the relationship between the area of abdominal VAT, SAT, BMI and the severity of OSA in the metabolic syndrome population. Draw receiver operating characteristics (ROC) based on OSA severity. ResultsA total of 65 patients were included in the study. According to the severity of OSA, the patients were divided into three groups: non OSA group, mild OSA group, moderate-to-severe OSA group. The area of VAT was related to the occurrence and severity of OSA (P<0.05). The area of VAT in patients with moderate-to-severe OSA was larger than that in the group without OSA and mild OSA group (P<0.05). BMI was not related to the occurrence of OSA (P>0.05), but related to the severity of OSA. BMI in moderate-to-severe OSA group was significantly higher than that in non OSA group and mild OSA group (P<0.05). The area of SAT was not related to the occurrence and severity of OSA. According to the ROC plotted with or without OSA, the area under curve (AUC) is 0.76, 95%CI: 0.63-0.89, P<0.001. The cut-off value of VAT area is 174.9 cm², the sensitivity is 80.5%, and the specificity is 62.5%. According to the ROC plotted mild or moderate-severe OSA, the AUC is 0.84. The cut-off value of VAT area is 218.2 cm², the sensitivity is 70.5%, and the specificity is 80.5%. ConclusionsIt is important to pay attention to the content of VAT in patients with moderate-to-severe OSA in the weight-loss metabolic population. The increase of BMI and VAT area in patients with moderate-to-severe OSA deserves attention. Abdominal MR scans use a single-level VAT area to analyze the relationship with the severity of OSA, which improves the understanding of abdominal fat in the pathogenesis of OSA.