肥胖指标在阻塞性睡眠呼吸暂停低通气综合征筛查中的应用

Application of obesity indexes for OSAHS screening

目的研究肥胖指标在筛查中年男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)中的作用。方法对51名参加OSAHS筛查的中年男性打鼾者进行身高、体重、颈围、腰臀比和人体成分的测定,对比5个指标对筛查OSAHS的诊断能力,分析肥胖指标用于筛查OSAHS的可行性及优劣。结果符合OSAHS诊断26例,不符合OSAHS诊断25名,OSAHS组的肥胖指标明显高于非OSAHS组,肥胖指标与OSAHS的严重程度正相关,肥胖指标对OSAHS有较好的诊断能力,按曲线下面积(area under curve,AUC)排列依次为内脏脂肪面积、腰臀比、颈围、体质量指数、体脂百分比(AUC 71.7%～78.5%),诊断切点值分别为100.9 cm2,0.89,37 cm,27.7 kg/m2,30.3%。用于诊断的阳性预测值和阴性预测值分别为77.8%,71%;61.8%,81.3%;56.3%,70.6%;70%,64.5%;70%,69%。结论肥胖参数可以用来筛查男性OSAHS,其中内脏脂肪面积用于诊断OSAHS,AUC、阳性预测值和特异性最高。

OBJECTIVE To discover the role of different obesity indexes for screening OSAHS in middle-aged male. METHODS body mass index(BMI),neck circumference(NC),waist-to-hip ratio(WHR) and body composition of 51 middle-aged snoring males were measured. By comparing the sensitivity,specificity,PPV,NPV and area under the ROC curve of 5 obesity indexes,the diagnosis ability of obesity indexes to screen OSAHS was assessed and the advantages and disadvatanges of different indexes were analyzed. R ESU LTS 25 par ticipants were diagnosed as OSAHS,and 26 were not. The obesity indexes in OSAHS group were significantly higher than those of non-OSAHS group,and were positively correlated with the severity of OSAHS. AUC was used to prove the diagnostic efficiency of the 5 obesity indexes for screening OSAHS and they were listed according to the order of AUC as: visceral fat area(VFA),WHR,NC,BMI and body fat percentage(BFP)(area under the curve varies from 71.7 to78.5%). The cutoff value,PPV and NPV of each index were listed as follows: 100.9 cm2,77.8%,71%;0.89,61.8%,81.3%;37 cm,56.3%,70.6%;27.7 kg/m2,70%,64.5%;30.3%,70%,69%. CONCLUSION Obesity indexes can be used to screen OSAHS in middle-aged males. visceral fat area,with the highest AUC,PPV and specificity,was superior to other obesity related indicators in screening OSAHS.