阻塞性睡眠呼吸暂停低通气综合征合并代谢综合征的患病情况及影响因素分析

Analysis of prevalence and influencing factors of OSAHS complicated with metabolic syndrome

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)合并代谢综合征(metabolic syndrome,MS)的患病情况,分析影响OSAHS合并MS的相关因素。方法 收集2020年8月至2022年10月在包头医学院第一附属医院住院并诊断为OSAHS的患者290例,根据患者是否合并MS分为OSAHS合并MS组(n=150)和单纯OSAHS组(n=140),并依据呼吸暂停低通气指数(apnea hypopnea index,AHI)将OSAHS合并MS组患者分为轻度组、中度组、重度组3个亚组。记录患者的一般情况、生化指标及睡眠参数,采用Logistic回归分析明确影响OSAHS合并MS的相关因素。结果 (1)290例OSAHS患者中,MS的合并率为51.7%,男性患者多于女性,50~59岁是OSASH合并MS患病的高峰期。(2)两组患者的体质量指数(body mass index,BMI)、收缩压、高血压史、糖尿病史、AHI、空腹血糖(fasting blood glucose,FBG)、三酰甘油(triglyceride,TG)、高密度脂蛋白-胆固醇(high density lipoprotein-cholesterol,HDL-C)、尿酸(uricacid,UA)的比较差异有统计学意义(P<0.05);Logistic回归分析显示,BMI、FBG、TG、HDL-C、UA、高血压史、糖尿病史是影响OSAHS合并MS的独立危险因素(P<0.05)。(3)不同严重程度的三组OSAHS合并MS患者的性别、年龄、BMI、AHI、TG、HDL-C、UA的比较差异有统计学意义(P<0.05),Logistic回归分析结果显示,BMI、TG、HDL-C是影响不同严重程度OSAHS合并MS的独立危险因素(P<0.05)。结论 住院OSAHS患者有较高的MS合并率。OSAHS合并MS与BMI、血压、血糖、血脂、尿酸水平等多种因素有关。超重和血脂异常在诱导疾病加重的过程中发挥重要作用。

Objective To investigate the prevalence of obstructive sleep apnea-hypopnea syndrome(OSAHS)combined with metabolic syndrome(MS),and analyze the related factors affecting OSAHS combined with MS.Methods Totally 290 patients with OSAHS hospitalized in the First Affiliated Hospital of Baotou Medical College and diagnosed as OSAHS were collected from August 2020 to October 2022.According to whether the patients were complicated with MS,they were divided into OSAHS combined with MS group and simple OSAHS group.According to apnea hypopnea index(AHI),the patients of OSAHS combined with MS group were divided into three subgroups:mild group,moderate group and severe group.The general condition,biochemical indicators and sleep parameters of patients were recorded,and the relevant factors affecting OSAHS with MS were determined by logistic regression analysis.Results(1)Among the 290 patients with OSAHS,the incidence of MS was 51.7%,male patients were more than female patients,and the peak of OSASH with MS was between 50 and 59 years old.(2)body mass index(BMI),systolic blood pressure,hypertension history,diabetes history,AHI,fasting blood glucose(FBG),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C),uric acid(UA)were statistically different between the two groups(P<0.05);Logistic regression analysis showed that BMI,FBG,TG,HDL-C,UA,history of hypertension and history of diabetes were independent risk factors for OSAHS with MS(P<0.05).(3)There were statistically significant differences in gender,age,BMI,AHI,TG,HDL-C and UA among the three groups of OSAHS with MS with different severity(P<0.05). Logistic regression analysis showed that BMI, TG and HDL-C were independent risk factors affecting OSAHS with MS with different severity (P<0.05). Conclusion (1) The inpatients with OSAHS have a high incidence of MS. (2) OSAHS combined with MS is related to BMI, blood pressure, blood glucose, blood lipid, blood uric acid level and other factors. (3) Overweight and dyslipidemia play an important role in the process of inducing disease aggravation.