Optimal Body Mass Index Cut-offs for Identification of Patients with Coronary Artery Disease at High Risk of Obstructive Sleep Apnoea
Optimal Body Mass Index Cut-offs for Identification of Patients with Coronary Artery Disease at High Risk of Obstructive Sleep Apnoea
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DOI：
10.1016/j.hlc.2016.02.010
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发表时间：
2016-08-01
影响因子：
2.6
通讯作者：
Lee, Chi-Hang
中科院分区：
文献类型：
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作者：
Chan, Po-Fun;Tai, Bee-Choo;Lee, Chi-Hang
背景：我们试图评估中国冠心病住院患者的体重指数（BMI）和阻塞性睡眠呼吸暂停（OSA）之间的关系，并确定预测OSA的最佳BMI截止值。以亚洲人为界，81.2%的队列超重（BMI >= 23 kg/m2），31.6%肥胖（>= 27 kg/m2）。共有59.5%被诊断为OSA，定义为呼吸暂停低通气指数>= 15。体重指数、高血压和吸烟是OSA的预测因素。多元逻辑回归分析显示，在调整吸烟和高血压后，BMI仍然是阻塞性睡眠呼吸暂停综合症的独立预测因素（比值比：1.11 [95%置信区间：1.06至1.17]，p < 0.001）。以BMI和呼吸暂停低通气指数（AHI）为连续变量进一步分析，BMI与AHI呈显著相关（Pearson's r = 0.25，P < 0.001）。在调整后的模型中，筛查OSA的最佳BMI截止值分别为27.3 kg/m2，23.0-23.9 kg/m2和20 kg/m2，对于既无预测因素，也无预测因素或两者都有预测因素（吸烟和高血压）的患者。校正模型和未校正模型的曲线下面积相似（0.6013vs0.6262，p = 0.118）。结论体重指数是一种方便、有效的诊断OSA高危患者的工具。本研究定义了中国症状性冠状动脉疾病患者中预测OSA风险的体重指数临界值。
Background We sought to evaluate the relationship between Body Mass Index (BMI) and obstructive sleep apnoea (OSA) in Chinese patients hospitalised with coronary artery disease, and to determine the optimal BMI cut-off for prediction of OSA.Methods Consecutive Chinese patients who were hospitalised with symptomatic coronary artery disease were recruited to undergo an in-hospital sleep study.Results A total of 587 patients were recruited. Using cut-off for Asians, 81.2% of the cohort was overweight (BMI >= 23 kg/m(2)) and 31.6% was obese (>= 27 kg/m(2)). A total of 59.5% was diagnosed with OSA, defined as apnoea-hypopnoea index >= 15. Body mass index, hypertension and smoking were predictors of OSA. Multiple logistic regression analysis showed that BMI remains an independent predictor of OSA (odds ratio: 1.11 [95% confidence interval: 1.06 to 1.17], p < 0.001) after adjusting for smoking and hypertension. Further analysis using BMI and Apnoea-Hypopnoea Index (AHI) as continuous variables showed significant correlation between BMI and AHI (Pearson's r = 0.25, P < 0.001). In adjusted models, optimal BMI cutoffs to screen for OSA were 27.3 kg/m(2), 23.0-23.9 kg/m(2), and 20 kg/m(2) for patients with neither, either, or both predictors (smoking and hypertension) respectively. The area under the curve for the adjusted and unadjusted models were similar (0.6013 vs 0.6262, p = 0.118).Conclusions Body mass index represents a convenient and readily available tool for bedside identification of patients at high risk of OSA. Body mass index cut-offs to predict risks of OSA in Chinese patients with symptomatic coronary artery disease are defined in this study.