阻塞性睡眠呼吸暂停综合征患者合并血脂异常的危险因素及预测模型研究

Risk factors and predictive models for dyslipidemia in patients with obstructive sleep apnea syndrome

摘要:

目的]探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者合并血脂异常的潜在及独立危险因素,构建可用于临床预测的风险模型,以期通过识别和干预可控因素,降低血脂异常及其相关心血管事件的发生风险。 [方法]回顾性纳入自2022年1月至2023年3月于山西医科大学第二医院行多导睡眠监测并诊断为OSAS的患者共181例,其中单纯OSAS患者76例,OSAS合并血脂异常患者105例,收集患者的一般资料、生物化学指标、多导睡眠监测指标,并采用Spearman相关分析、单因素和多因素Logistic回归模型分析OSAS患者合并血脂异常的独立危险因素。 [结果]与单纯OSAS组相比,OSAS合并血脂异常组患者的年龄偏低,体重指数(BMI)、单核细胞计数/高密度脂蛋白胆固醇比值(MHR)、甘油三酯/高密度脂蛋白胆固醇比值(TG/HDLC)、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值(LDLC/HDLC)、甘油三酯葡萄糖指数(TyG)更高(P＜0.05),而高密度脂蛋白胆固醇(HDLC)、非快速眼动2期水平显著降低。Spearman相关分析显示,甘油三酯(TG)水平、TG/HDLC与呼吸暂停低通气指数(AHI)正相关(r＝0.205,P＝0.006；r＝0.210,P＝0.005)；HDLC水平与AHI负相关(r＝－0.169,P＝0.024),且与非快速眼动2期正相关(r＝0.156,P＝0.038)。多因素Logistic回归分析显示,TG/HDLC和MHR的增高是OSAS合并血脂异常的独立危险因素及预测指标(P＜0.05)。 [结论]高TG/HDLC和高MHR是OSAS合并血脂异常的独立危险因素及预测指标,预测效果较强,对OSAS患者冠心病早期预防具有重要意义。

Abstract:

Aim To explore the potential and independent risk factors associated with dyslipidemia in patients with obstructive sleep apnea syndrome (OSAS), and construct a predictive model for clinical use, with the goal of reducing the risk of dyslipidemia and subsequent cardiovascular events through early identification and intervention of modifiable factors. Methods A retrospective study was conducted on 181 patients diagnosed with OSAS who underwent polysomnography monitoring at the Second Hospital of Shanxi Medical University from January 2022 to March 2023. Among them, there were 76 patients with OSAS alone and 105 patients with OSAS complicated by dyslipidemia. General information, biochemical indicators, and polysomnography monitoring indicators of the patients were collected, and Spearman correlation analysis, univariate and multivariate Logistic regression models were used to analyze the independent risk factors of OSAS patients complicated with dyslipidemia. Results Compared with the OSAS alone group, the OSAS with dyslipidemia group had lower age, higher body mass index (BMI), monocyte count/high density lipoprotein cholesterol ratio (MHR), triglyceride/high density lipoprotein cholesterol ratio (TG/HDLC), low density lipoprotein cholesterol/high density lipoprotein cholesterol ratio (LDLC/HDLC), and triglyceride glucose index (TyG) (P＜0.05), while high density lipoprotein cholesterol (HDLC) and non-rapid eye movement stage 2 sleep levels were significantly reduced. Spearman correlation analysis showed that triglyceride (TG) and TG/HDLC were positively correlated with the apnea hypopnea index (AHI) (r＝0.205, P＝0.006; r＝0.210, P＝0.005), while HDLC was negatively correlated with AHI (r＝－0.169, P＝0.024) and positively correlated with non-rapid eye movement stage 2 sleep (r＝0.156, P＝0.038). Multivariate logistic regression analysis showed that elevated TG/HDLC and MHR were independent risk factors and predictive indicators for OSAS complicated with dyslipidemia (P＜0.05). Conclusion High TG/HDLC and high MHR are independent risk factors and predictive indicators for OSAS complicated with dyslipidemia, with strong predictive value, and are of great significance for early prevention of coronary heart disease in OSAS patients.