Clinical features of obstructive sleep apnea-hypopnea syndrome with overweight or obesity and related influencing factors

Wen Yi; Xie Shiqi; Zhou Jianrong; Yang Xia; Liu Yue; Chen Jinglan

doi:10.13406/j.cnki.cyxb.003372

您当前的位置：

首页 >

文章列表页 >

Clinical features of obstructive sleep apnea-hypopnea syndrome with overweight or obesity and related influencing factors

Clinical research | 更新时间：2025-10-22

- Clinical features of obstructive sleep apnea-hypopnea syndrome with overweight or obesity and related influencing factors
- Journal of Chongqing Medical University Vol. 48, Issue 11, Pages: 1387-1392(2023)
- 作者机构：
  
  重庆医科大学护理学院，重庆 400016
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003372
  CLC： R766
- Received：29 September 2023，
  
  Revised：2023-10-26，
  
  Accepted：30 October 2023，
  
  Published：28 November 2023
- 稿件说明：
移动端阅览
文艺,谢世麒,周建荣,等.阻塞性睡眠呼吸暂停低通气综合征合并超重或肥胖的临床特征及影响因素研究[J].重庆医科大学学报,2023,48(11):1387-1392.

Wen Yi,Xie Shiqi,Zhou Jianrong,et al.Clinical features of obstructive sleep apnea-hypopnea syndrome with overweight or obesity and related influencing factors[J].Journal of Chongqing Medical University,2023,48(11):1387-1392.
文艺,谢世麒,周建荣,等.阻塞性睡眠呼吸暂停低通气综合征合并超重或肥胖的临床特征及影响因素研究[J].重庆医科大学学报,2023,48(11):1387-1392. DOI： 10.13406/j.cnki.cyxb.003372.

Wen Yi,Xie Shiqi,Zhou Jianrong,et al.Clinical features of obstructive sleep apnea-hypopnea syndrome with overweight or obesity and related influencing factors[J].Journal of Chongqing Medical University,2023,48(11):1387-1392. DOI： 10.13406/j.cnki.cyxb.003372.

摘要

目的

比较有无超重或肥胖的阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopnea syndrome，OSAHS）患者的临床特征和睡眠结构差异，并分析其影响因素。

方法

回顾性分析2020年1月至2021年4月在重庆医科大学附属第一医院就诊的458例OSAHS患者临床资料和多导睡眠监测（polysomnography，PSG）结果，根据体质指数（body mass index，BMI）分为单纯OSAHS组和OSAHS合并超重或肥胖组，单纯OSAHS组91例（19.9%），OSAHS合并超重或肥胖组367例（80.1%）。比较两组患者的临床资料和PSG结果，采用单因素分析和回归分析超重或肥胖患者发生OSAHS的影响因素。

结果

两组患者在颈围、腰围、OSAHS严重程度、日间嗜睡评分、高血压史、2型糖尿病史、呼吸暂停低通气指数（apnea hypopnea index，AHI）、微觉醒指数、夜间平均氧饱和度（mean oxygen saturation，MSaO

）和夜间最低氧饱和度（lowest oxygen saturation，LSaO

）比较，差异有统计学意义（

0.05）；OSAHS合并超重或肥胖患者的多因素回归分析结果显示BMI（

=2.639，

=0.009）、家族打鼾史（

=-2.521，

=0.001 2）、微觉醒指数（

=12.813，

=0.000）和LSaO

（

=-7.407，

=0.000）是主要影响因素。

结论

有无超重或肥胖的OSAHS患者在临床特征和睡眠结构间具有差异性。BMI升高、有家族打鼾史、微觉醒指数增加及夜间LSaO

降低是超重或肥胖患者合并OSAHS的独立危险因素。

Abstract

Objective

To investigate the differences in clinical features and sleep structure between patients with obstructive sleep apnea-hypopnea syndrome（OSAHS） with or without overweight/obesity，as well as related influencing factors.

Methods

A retrospective analysis was performed for the clinical data and polysomnography（PSG） results of 458 OSAHS patients who attended The First Affiliated Hospital of Chongqing Medical University from January 2020 to April 2021，and according to body mass index（BMI），they were divided into OSAHS group and OSAHS+overweight/obesity group. For all 458 patients，there were 91 patients（19.9%） in the OSAHS group and 367 patients（80.1%） in the OSAHS+overweight/obesity group. Clinical data and PSG results were compared between the two groups，and univariate analysis and regression analyses were used to explore the influencing factors for OSAHS in patients with overweight or obesity.

Results

There were significant differences between the two groups in neck circumference，waist circumference，OSAHS severity，daytime sleepiness score，history of hypertension，history of type 2 diabetes mellitus，apnea hypopnea index，microarousal index，mean oxygen saturation（MSaO

） at night，and lowest oxygen saturation（LSaO

） at night（all

0.05）. The multivariate regression analysis showed that BMI（

=2.639，

=0.009），the family history of snoring（

=-2

.521，

=0.0012），microarousal index（

=12.813，

=0.000），and LSaO

（

=-7.407，

=0.000） were the main influencing factors for OSAHS in patients with overweight or obesity.

Conclusion

There are differences in clinical features and sleep structure between the OSAHS patients with or without overweight/obesity，and elevated BMI，the family history of snoring，an increase in microarousal index，and a reduction in LSaO

are independent risk factors for OSAHS in patients with overweight or obesity.

关键词

Keywords

references

Veasey SC ， Rosen IM . Obstructive sleep apnea in adults [J ] . N Engl J Med ， 2019 ， 380 （ 15 ）： 1442 - 1449 .

Heinzer R ， Vat S ， Marques-Vidal P ， et al . Prevalence of sleep-disordered breathing in the general population：the HypnoLaus study [J ] . Lancet Respir Med ， 2015 ， 3 （ 4 ）： 310 - 318 .

Qian YY ， Dharmage SC ， Hamilton GS ， et al . Longitudinal risk factors for obstructive sleep apnea：a systematic review [J ] . Sleep Med Rev ， 2023 ， 71 ： 101838 .

Turnbull CD ， Wang SH ， Manuel AR ， et al . Relationships between MRI fat distributions and sleep apnea and obesity hypoventilation syndrome in very obese patients [J ] . Schlaf Atmung ， 2018 ， 22 （ 3 ）： 673 - 681 .

Skolnik NS ， Ryan DH . Pathophysiology，epidemiology，and assessment of obesity in adults [J ] . J Fam Pract ， 2014 ， 63 （ 7 Suppl ）： S3 - S10 .

Peppard PE ， Young T ， Palta M ， et al . Longitudinal study of moderate weight change and sleep-disordered breathing [J ] . JAMA ， 2000 ， 284 （ 23 ）： 3015 - 3021 .

St-Onge MP . Sleep-obesity relation：underlying mechanisms and consequences for treatment [J ] . Obes Rev ， 2017 ， 18 （ Suppl 1 ）： 34 - 39 .

中华医学会呼吸病学分会睡眠呼吸障碍学组 . 阻塞性睡眠呼吸暂停低通气综合征诊治指南（2011年修订版） [J ] . 中华结核和呼吸杂志， 2012 ， 35 （ 1 ）： 9 - 12 .

Sleep Breathing Disorders Group of the Chinese Thoracic Society . Guidelines for the Diagnosis and Treatment of Obstructive Sleep Apnea-hypopnea Syndrome（2011 Revision） [J ] . Chin J Tuberc Respir Dis ， 2012 ， 35 （ 1 ）： 9 - 12 .

Johns MW . A new method for measuring daytime sleepiness：the Epworth sleepiness scale [J ] . Sleep ， 1991 ， 14 （ 6 ）： 540 - 545 .

Punjabi NM . The epidemiology of adult obstructive sleep apnea [J ] . Proc Am Thorac Soc ， 2008 ， 5 （ 2 ）： 136 - 143 .

Lagares LS ， Lino RS ， Bomfim ES ， et al . Anthropometric measures for the prognosis of obstructive sleep apnea in obese [J ] . Clin Med Res ， 2022 ， 20 （ 3 ）： 147 - 152 .

Zou JJ ， Wang YY ， Xu HJ ， et al . The use of visceral adiposity variables in the prediction of obstructive sleep apnea：evidence from a large cross-sectional study [J ] . Sleep Breath ， 2020 ， 24 （ 4 ）： 1373 - 1382 .

Soylu AC ， Levent E ， Sarıman N ， et al . Obstructive sleep apnea syndrome and anthropometric obesity indexes [J ] . Sleep Breath ， 2012 ， 16 （ 4 ）： 1151 - 1158 .

Banhiran W ， Junlapan A ， Assanasen P ， et al . Physical predictors for moderate to severe obstructive sleep apnea in snoring patients [J ] . Schlaf Atmung ， 2014 ， 18 （ 1 ）： 151 - 158 .

Kumar P ， Rai DK ， Kanwar MS . Comparison of clinical and polysomnographic parameters between obese and nonobese obstructive sleep apnea [J ] . J Family Med Prim Care ， 2020 ， 9 （ 8 ）： 4170 - 4173 .

Liu CL ， Chen MS ， Yu H . The relationship between obstructive sleep apnea and obesity hypoventilation syndrome：a systematic review and meta-analysis [J ] . Oncotarget ， 2017 ， 8 （ 54 ）： 93168 - 93178 .

徐　悠，毛洪京，余正和，等 . 阻塞性睡眠呼吸暂停低通气综合征患者主观睡眠质量的性别差异及影响因素 [J ] . 中国现代医生， 2021 ， 59 （ 17 ）： 85 - 90 .

Xu Y ， Mao HJ ， Yu ZH ， et al . Gender differences and influencing factors of subjective sleep quality in patients with obstructive sleep apnea hypopnea syndrome [J ] . China Mod Dr ， 2021 ， 59 （ 17 ）： 85 - 90 .

Liu YP ， Zou JY ， Qian YJ ， et al . The association between obesity indices and obstructive sleep apnea is modified by age in a sex-specific manner [J ] . Schlaf Atmung ， 2021 ， 25 （ 1 ）： 189 - 197 .

贺　媛，曾　强，赵小兰 . 中国成人肥胖、中心性肥胖与高血压和糖尿病的相关性研究 [J ] . 解放军医学杂志， 2015 ， 40 （ 10 ）： 803 - 808 .

He Y ， Zeng Q ， Zhao XL . Association of body mass index and waist circumstance with risk of hypertension and diabetes in Chinese adults [J ] . Med J Chin People’s Liberation Army ， 2015 ， 40 （ 10 ）： 803 - 808 .

Bhatheja S ， Panchal HB ， Ventura H ， et al . Obesity cardiomyopathy：pathophysiologic factors and nosologic reevaluation [J ] . Am J Med Sci ， 2016 ， 352 （ 2 ）： 219 - 222 .

Engin A . The definition and prevalence of obesity and metabolic syndrome [J ] Adv Exp Med Biol ， 2017 ， 960 ： 1 - 17 .

Javaheri S ， Barbe F ， Campos-Rodriguez F ， et al . Sleep apnea：types，mechanisms，and clinical cardiovascular consequences [J ] . J Am Coll Cardiol ， 2017 ， 69 （ 7 ）： 841 - 858 .

Spiegel K ， Knutson K ， Leproult R ， et al . Sleep loss：a novel risk factor for insulin resistance and Type 2 diabetes [J ] . J Appl Physiol ， 2005 ， 99 （ 5 ）： 2008 - 2019 .

Basoglu OK ， Tasbakan MS . Comparison of clinical characteristics in patients with obesity hypoventilation syndrome and obese obstructive sleep apnea syndrome：a case-control study [J ] . Clin Respir J ， 2014 ， 8 （ 2 ）： 167 - 174 .

Littleton SW ， Tulaimat A . The effects of obesity on lung volumes and oxygenation [J ] . Respir Med ， 2017 ， 124 ： 15 - 20 .

Osman AM ， Carter SG ， Carberry JC ， et al . Obstructive sleep apnea：current perspectives [J ] . Nat Sci Sleep ， 2018 ， 10 ： 21 - 34 .

Kalra M ， Lemasters G ， Bernstein D ， et al . Atopy as a risk factor for habitual snoring at age 1 year [J ] . Chest ， 2006 ， 129 （ 4 ）： 942 - 946 .

Zhang DM ， Xiao Y ， Luo JM Genetics of obstructive sleep apnea/hypopnea syndrome [J ] . Chin Med J ， 2014 ， 127 （ 17 ）： 3135 - 3141 .

Altree TJ ， Bartlett DJ ， Marshall NS ， et al . Predictors of weight loss in obese patients with obstructive sleep apnea [J ] . Schlaf Atmung ， 2022 ， 26 （ 2 ）： 753 - 762 .

Johansson K ， Hemmingsson E ， Harlid R ， et al . Longer term effects of very low energy diet on obstructive sleep apnoea in cohort derived from randomised controlled trial：prospective observational follow-up study [J ] . BMJ ， 2011 ， 342 ： d3017 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Exploring the clinical prognostic factors in endometrial stromal sarcoma

Survey on components of the metabolic syndrome and analysis of its influencing factors among 7-16 years old children and adolescents in Chongqing

Influencing factors for early postoperative kinesiophobia in school-aged children after limb fracture surgery: a qualitative study

Research status of GLP-1 receptor agonists in the treatment of obesity

Influencing factors for dysphagia in the elderly and establishment of a predictive model

Related Author

Meng Yu

Du Ying

Gong Sainan

Mu Xiaoling

Wang Yanyan

Xiong Feng

Zhang Yani

Yang Bin

Related Institution

Department of Gynecology，The First Affiliated Hospital of Chongqing Medical University

Physical Examination Center，University Town Hospital Affiliated to Chongqing Medical University

Department of Endocrinology,the Children’s Hospital,Chongqing Medical University

Primary and Secondary School Health Institute of Shapingba District of Chongqing

Department of Orthopedics，Children’s Hospital of Chongqing Medical University，National Clinical Research Center for Child Health and Disorders，Ministry of Education Key Laboratory of Child Development and Disorders，Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases

⁰