不良摄食行为在超重/肥胖与阻塞性睡眠呼吸暂停之间的中介效应  

The mediating effect of poor eating behavior between overweight/obesity and obstructive sleep apnea

作　　者：王豪冬 魏春生[1] 马建红 黄晶晶[1] WANG Haodong;WEI Chunsheng;MA Jianhong(Eye and ENT Hospital of Fudan University,Shanghai 201114,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院,上海市201114

出　　处：《精神医学杂志》2024年第4期348-352,共5页Journal of Psychiatry

基　　金：上海市临床重点专科双一流项目(编号:shslczdzk00801);上海市闵行区自然科学基金(编号:2022M11Z086);复旦大学附属眼耳鼻喉科医院(编号:YGJC026)。

摘　　要：目的探讨不良摄食行为在超重/肥胖(OW/OB)与阻塞性睡眠呼吸暂停(OSA)之间的中介效应。方法选取125例住院OSA合并OW/OB患者行三因素饮食问卷(TFEQ-R21)调查。根据患者体质量指数(BMI)分为三组,分别为超重组、肥胖一组和肥胖二组,通过多重线性回归分析评估OW/OB及不良摄食行为(即TFEQ-R21认知约束进食、失控进食和情绪化进食3个维度)与OSA之间的关联,并使用系数乘积检验中的Sobel检验评估不良摄食行为在OW/OB与OSA之间的中介效应。结果三组AHI、BMI比较差异均有统计学意义(P<0.001)。三组TFEQ-R21总分及失控进食维度评分比较差异均有统计学意义(P<0.01)。BMI与AHI值呈正相关(P<0.01);TFEQ-R21失控进食维度评分与BMI、AHI值呈正相关(P<0.01)。三组TFEQ-R21失控进食维度中项目3、项目8、项目13和项目15评分比较差异均有统计学意义(P<0.01)。进一步进行多重线性回归分析,结果显示该模型对数据的拟合程度较好(R=0.520),构建的多重线性回归模型具有统计学意义(P<0.01),OSA总变异的27.1%可由失控进食维度评分和BMI来解释(R^(2)=0.271)。中介效应分析结果显示,TFEQ-R21失控进食可能部分介导OW/OB与OSA之间关联的总效应,“OW/OB→失控进食→OSA”中介途径有统计学意义(P<0.01),失控进食中介效应占比为14.40%。结论OSA与OW/OB和不良摄食行为相关,其中失控进食可能部分介导OW/OB与OSA之间关联的总效应。Objective To explore the mediating effect of poor eating behavior between overweight/obesity(OW/OB)and obstructive sleep apnea(OSA).Methods A total of 125 hospitalized patients with OSA combined with OW/OB were selected and assessed with Three-Factor Eating Questionnaire(TFEQ-R21).All patients were divided into overweight group,obesity one group and obesity two group according to their body mass indexes(BMIs).The association between OW/OB,poor eating behavior(i.e.,cognitive restraint,uncontrolled eating,and emotional eating)and OSA was assessed by linear regression analyses and the mediating effect of poor eating behavior on the association between OW/OB and OSA was evaluated through Sobel test of the coeffcient product test.Results There existed significant differences in AHI,BMI,total score and uncontrolled eating dimension score of TFEQ-R21 among three groups(P<0.01).BMI was positively correlated with AHI(P<0.01).The uncontrolled eating dimension score of TFEQ-R21 was positively correlated with BMI and AHI(P<0.01).There existed significant dfferences in scores of items 3,8,13,15 of uncontrolled eating dimension score of TFEQ-R21(P<0.01).Multiple linear regression analysis showed that the data fitted well(R=0.520,P<0.01).Uncontrolled eating dimension score of TFEQ-R21 and BMI could explain 27.1%of the total variation of OSA(R^(2)=0.271).The mediation analysis showed that the mediation pathway"OW/OB-→uncontrolled eating→OSA"was statistically significant in the association between OW/OB and OSA(P<0.01),and the mediation effect of uncontrolled eating accounted for 14.40%.Conclusion OSA is associated with OW/OB and poor eating behavior,in which uncontrolled eating may partially mediate the total effect of the association between OW/OB and OSA.

关 键 词：摄食行为 失控进食 阻塞性睡眠呼吸暂停 中介效应 肥胖 三因素饮食问卷 

分 类 号：R766[医药卫生—耳鼻咽喉科] R589.2[医药卫生—临床医学]