Sleep Apnea and 20-Year Follow-Up for All-Cause Mortality, Stroke, and Cancer Incidence and Mortality in the Busselton Health Study Cohort
Sleep Apnea and 20-Year Follow-Up for All-Cause Mortality, Stroke, and Cancer Incidence and Mortality in the Busselton Health Study Cohort
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DOI：
10.5664/jcsm.3600
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发表时间：
2014-01-01
影响因子：
4.3
通讯作者：
Grunstein, Ronald R.
中科院分区：
文献类型：
--
作者：
Marshall, Nathaniel S.;Wong, Keith K. H.;Grunstein, Ronald R.
目的：为了确定客观测量的阻塞性睡眠呼吸暂停（OSA）是否独立增加全因死亡、心血管疾病（CVD）、冠心病（CHD）、中风或癌症的风险，设计：基于社区的队列设置和参与者：西澳大利亚Busselton镇的400名居民。OSA严重程度通过呼吸紊乱指数（RDI）来量化，呼吸紊乱指数（RDI）通过使用MESAM IV设备在1990年11月至12月的单夜记录来测量，沿着一系列其他风险因素。结果：共获得397例随访资料，其中4例既往有脑卒中史，7例有癌症史。在20年的随访中，有77例死亡，103例心血管事件（31例中风，59例冠心病）和125例癌症事件（39例癌症死亡）。在完全校正的模型中，中重度OSA与全因死亡率显著相关（HR = 4.2; 95% CI 1.9，9.2），癌症死亡率（3.4; 1.1，10.2）、偶发癌症（2.5; 1.2，5.0）和中风（3.7; 1.2，11.8），但与CVD（1.9; 0.75，4.6）或CHD发病率（1.1; 0.24，4.6）无显著性差异。轻度睡眠呼吸暂停与死亡率减半（0.5; 0.27，0.99），但没有其他的结果，控制后的主要危险factors.Conclusions：中度至重度睡眠呼吸暂停是独立相关的一个大的风险增加的全因死亡率，中风事件，癌症的发病率和死亡率在这个社区为基础的样本。
Objective: To ascertain whether objectively measured obstructive sleep apnea (OSA) independently increases the risk of all cause death, cardiovascular disease (CVD), coronary heart disease (CHD), stroke or cancerDesign: Community-based cohortSetting and Participants: 400 residents of the Western Australian town of BusseltonMeasures: OSA severity was quantified via the respiratory disturbance index (RDI) as measured by a single night recording in November-December 1990 using the MESAM IV device, along with a range of other risk factors. Follow-up for deaths and hospitalizations was ascertained via record linkage to the end of 2010.Results: We had follow-up data in 397 people and then removed those with a previous stroke (n = 4) from the mortality/CVD/CHD/stroke analyses and those with cancer history from the cancer analyses (n = 7). There were 77 deaths, 103 cardiovascular events (31 strokes, 59 CHD) and 125 incident cases of cancer (39 cancer fatalities) during 20 years follow-up. In fully adjusted models, moderate-severe OSA was significantly associated with all-cause mortality (HR = 4.2; 95% CI 1.9, 9.2), cancer mortality (3.4; 1.1, 10.2), incident cancer (2.5; 1.2, 5.0), and stroke (3.7; 1.2, 11.8), but not significantly with CVD (1.9; 0.75, 4.6) or CHD incidence (1.1; 0.24, 4.6). Mild sleep apnea was associated with a halving in mortality (0.5; 0.27, 0.99), but no other outcome, after control for leading risk factors.Conclusions: Moderate-to-severe sleep apnea is independently associated with a large increased risk of all-cause mortality, incident stroke, and cancer incidence and mortality in this community-based sample.