Obstructive sleep apnea is a risk factor for Barrett's esophagus.
Obstructive sleep apnea is a risk factor for Barrett's esophagus.
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DOI：
10.1016/j.cgh.2013.08.043
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发表时间：
2014-04
期刊：
影响因子：
--
通讯作者：
Iyer PG
中科院分区：
文献类型：
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作者：
Leggett CL;Gorospe EC;Calvin AD;Harmsen WS;Zinsmeister AR;Caples S;Somers VK;Dunagan K;Lutzke L;Wang KK;Iyer PG
阻塞性睡眠呼吸暂停 (OSA) 和巴雷特食管 (BE) 的常见危险因素包括肥胖和胃食管反流病 (GERD)。本研究的目的是评估 OSA 和 BE 之间的关联，并确定该关联是否独立于 GERD 和体重指数 (BMI)。使用 Mayo Clinic（明尼苏达州罗彻斯特）数据库从 2000 年 1 月至 2011 年 11 月期间，对接受过诊断性多导睡眠图和食管胃十二指肠镜检查的患者进行识别。将多导睡眠图检查时的年龄、性别和 BMI 随机匹配到以下组：BE 但无 OSA (n=36)、OSA 但没有 BE (n=78)、两者都有 (n=74) 或两者都没有 (n=74)。临床和人口统计学变量是从病历中提取的。使用多变量逻辑模型评估 OSA 和 BE 之间的关联，该模型纳入了年龄、性别、BMI、GERD 的临床诊断和吸烟史。与没有 OSA 的受试者相比，患有 OSA 的受试者发生 BE 的风险增加 80%（比值比 [OR]，1.8；95% 置信区间 [CI]，1.1–3.2；P=.03）。这些发现与年龄、性别、体重指数、胃食管反流病和吸烟史无关。使用呼吸暂停低通气指数 (AHI) 测量的 OSA 严重程度增加与 BE 风险增加相关（OR，AHI 每增加 10 个单位，增加 1.2 个单位；95% CI，1.0–1.3；P=.03）。在这项病例对照研究中，OSA 可能通过 BMI 和 GERD 独立机制与 BE 风险增加相关。 OSA 患者可能会受益于 BE 评估。
Common risk factors for obstructive sleep apnea (OSA) and Barrett's esophagus (BE) include obesity and gastroesophageal reflux disease (GERD). Aims of this study were to assess the association between OSA and BE and determine if the association is independent of GERD and body mass index (BMI) Patients who had undergone a diagnostic polysomnogram and an esophagogastroduodenoscopy were identified using Mayo Clinic (Rochester, Minnesota) databases from January 2000 through November 2011. They were randomly matched for age, sex, and BMI at time of polysomnogram into the following groups: BE but no OSA (n=36), OSA but no BE (n=78), both (n=74), or neither (n=74). Clinical and demographic variables were abstracted from medical records. The association between OSA and BE was assessed using a multiple variable logistic model that incorporated age, sex, BMI, a clinical diagnosis of GERD, and smoking history. Subjects with OSA had an 80% increased risk for BE compared to subjects without OSA (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1–3.2; P=.03). These findings were independent of age, sex, BMI, GERD, and smoking history. Increasing severity of OSA, measured using the Apnea Hypopnea Index (AHI), was associated with an increased risk of BE (OR, 1.2 per 10 units increase in AHI; 95% CI, 1.0–1.3; P=.03). In this case-control study, OSA was associated with an increased risk of BE, potentially through BMI and GERD independent mechanisms. Patients with OSA may benefit from evaluation for BE.