血清25-羟基维生素D缺乏与重度阻塞性睡眠呼吸暂停综合征的关系

Study on the relationship between serum 25-hydroxyvitamin D deficiency and severe obstructive sleep apnea syndrome

目的探讨血清25-羟基维生素D[25(OH)D]缺乏与重度阻塞性睡眠呼吸暂停综合征(OSAS)之间的关系。方法连续入选2016年4—12月就诊于新疆维吾尔自治区人民医院病人1017例,所有受试者均完善多导联睡眠监测并留取血清标本,最终纳入重度OSAS病人144例,非OSAS病人180例。采用电化学发光的方法测定血清25(OH)D水平,根据血清25(OH)D水平是否<20 ng/mL分为维生素D缺乏组和非缺乏组。结果在总体人群及女性人群中,按照年龄是否>45岁分层后,25(OH)D缺乏组重度OSAS病人构成比显著高于25(OH)D非缺乏组(总体人群:51.1%比31.0%,P=0.022;女性人群:29.7%比9.3%,P=0.012)。此外,在年龄>45岁组中,25(OH)D缺乏组的睡眠呼吸紊乱指数[32.95(2.80~55.78)比3.65(1.13~40.45)]、阻塞次数[38.50(1.00~170.00)次比4.00(0~190.75)次]和阻塞性指数[5.95(0.20~25.90)比0.50(0~26.08)]以及总呼吸暂停次数[48.00(1.00~190.00)比4.00(0~206.50)]显著高于年龄≤45岁组(均P<0.05)。logistic回归模型显示,25(OH)D缺乏可能是男性发生重度OSAS的危险因素(P=0.036)。而年龄增加可能是女性重度OSAS发生的危险因素(P<0.001)。结论年龄>45岁组中,25(OH)D缺乏组中重度OSAS构成比显著高于25(OH)D非缺乏组。此外,血清25(OH)D缺乏可能是男性发生重度OSAS的危险因素,年龄增长可能是女性重度OSAS发生的危险因素。

Objective To explore the relationship between serum 25-hydroxyvitamin D[25(OH)D]deficiency and severe obstructive sleep apnea syndrome(OSAS).MethodsA total of 324 subjects were included in this study,including 144 patients with severe OSAS and 180 patients non-OSAS.The serum and general clinical data of all subjects were collected in the People’s Hospital of Xinjiang Uygur Autonomous Region from March to December 2016.The serum levels of 25(OH)D was detected by electrochemiluminescence.ResultsThe proportion of OSAS in 25(OH)D deficiency group was significantly higher compare with 25(OH)D non-deficiency group in age>45 years group(P=0.022).The proportion of severe OSAS in the age group>45 years was significantly higher compare with age≤45 years group in the female group(P=0.012).In addition,in 25(OH)D deficiency group,the respiratory disorder index(RDI)[32.95(2.80-55.78)vs.3.65(1.13-40.45)],obstructive events[38.50(1.00-170.00)vs.4.00(0-190.75)]and indexes[5.95(0.20-25.90)vs.0.50(0-26.08)],and total apnea events[48.00(1.00-190.00)vs.4.00(0-206.50)]were significantly higher in age>45 years group compare with age≤45 years group(all P<0.05).Logistic regression model showed that the lower 25(OH)D levels may be a risk factor of OSAS in males(P=0.036).However,the increasing age acted as risk factor of severe OSAS in females(P<0.001).Conclusion In age>45 years group,the proportion of severe OSAS in 25(OH)D deficiency group is significantly higher than in 25(OH)D non-deficiency group.In the female group,the proportion of severe OSAS is significantly higher in age>45 years group compare with age≤45 years group.In addition,serum 25(OH)D deficiency may be a risk factor for OSAS in males,and age increase may be a risk factor for OSAS in females.