维生素D缺乏和超重与轻度阻塞性睡眠呼吸暂停的关联分析  

Association between vitamin D deficiency,overweight and mild obstructive sleep apnea

作　　者：邱伟 都勇[2] 李荣 李昂 Qiu Wei;Du Yong;Li Rong;Li Ang(Pujing Community Health Service Center of Minhang District,Shanghai 201102,China;Department of Respiratory and Critical Care Medicine,Shanghai Fifth People′s Hospital,Fudan University,Shanghai 200240,China)

机构地区：[1]上海市闵行区浦锦社区卫生服务中心,上海201112 [2]复旦大学附属上海市第五人民医院呼吸与危重症医学科,上海200240

出　　处：《中华全科医师杂志》2025年第3期296-300,共5页Chinese Journal of General Practitioners

基　　金：复旦大学社区健康研究中心社区健康科研课题(2020SJ11)。

摘　　要：目的探讨维生素D缺乏和超重与轻度阻塞性睡眠呼吸暂停(OSA)之间的关联。方法该研究为横断面研究。2020年1月1日至2022年12月31日,纳入上海市闵行区浦锦社区卫生服务中心及上海市第五人民医院医联体诊断的轻度OSA患者并匹配同期门诊就诊的非OSA患者各82例,所有患者均行多导睡眠监测检查,分别记录睡眠呼吸暂停低通气指数(AHI)及夜间最低血氧饱和度(LpO_(2)),并于空腹采集静脉血,检测血清中维生素D浓度,比较两组患者一般资料及OSA可能相关因素差异,并通过logistic回归分析筛选轻度OSA的患病关联因素。结果164例患者中,男性109例(66.46%),女性55例(33.54%)。轻度OSA组扁桃体肥大[32.90%(27/82)比18.29%(15/82)]、吸烟[52.40%(43/82)比35.37%(29/82)]、过敏性鼻炎[24.39%(20/82)比12.20%(10/82)]患者占比均高于非OSA组(χ^(2)=4.609、4.853、4.080,均P<0.05);轻度OSA组BMI高于非OSA组[(26.23±4.21)比(21.85±1.36)kg/m^(2),t=2.517,P<0.05],血清维生素D水平低于非OSA组[(12.36±7.98)比(23.56±9.32)pg/ml,t=-11.818,P<0.05];两组患者饮酒[39.02%(32/82)比34.15%(28/82),χ^(2)=0.421]、OSA家族史[9.76%(8/82)比6.10%(5/82),χ^(2)=0.752]情况差异无计学意义(均P>0.05)。多因素logistic回归分析结果显示,超重(OR=1.227,95%CI:1.045~1.441,P<0.05)与患轻度OSA呈正向关联;维生素D水平(OR=0.904,95%CI:0.832~0.981,P<0.05)与患轻度OSA呈负向关联;超重与维生素D缺乏共同存在时,患者发生轻度OSA的危险性为5.638,超过维生素D缺乏和超重单一因素存在的危险性(1.375,2.216)(P<0.05)。结论维生素D缺乏与超重是发生轻度OSA患病的正向关联因素,两者之间存在正交互作用;OSA筛查时应关注维生素D缺乏和超重人群。Objective To investigate the association between vitamin D deficiency,overweight and mild obstructive sleep apnea(OSA).Methods The study was a cross-sectional study.A total of 82 mild OSA patients diagnosed in Pujin Community Health Service Center of Shanghai Minhang District and the medical consortium of Shanghai Fifth People′s Hospital from January to December 2022 were enrolled,and 82 non-OSA patients visiting outpatient clinics at the same period were selected as controls.All participants underwent polysomnography monitoring and AHI and LpO_(2)were recorded.Venous blood was collected and serum vitamin D concentration was detected by ELISA method.The associated factors of mild OSA were determined with logistic regression analysis.Results The prevalence of tonsillar hypertrophy(32.90%(27/82)vs.18.29%(15/82)),smoking(52.4%(43/82)vs.35.37%(29/82))and allergic rhinitis(24.39%(20/82)vs.12.20%(10/82))in mild OSA group was significantly higher than that in the control group(χ^(2)=4.609,4.853 and 4.080,all P<0.05).The mild OSA group had a higher BMI((26.23±4.21)kg/m^(2)vs.(21.85±1.36)kg/m^(2),t=2.517,P<0.05)and lower serum vitamin D level((12.36±7.98)pg/ml vs.(23.56±9.32)pg/ml,t=-11.818,P<0.05)compared with the non-OSA group.There were no significant differences in rates of alcohol consumption(39.02%(32/82)vs.34.15%(28/82))and family history of OSA(9.76%(8/82)vs.6.10%(5/82),χ^(2)=0.752)between the two groups.Multivariate logistic regression analysis showed that overweight(OR=1.227,95%CI:1.045-1.441,P<0.05)was an independent risk factor for mild OSA,while vitamin D level(OR=0.904,95%CI:0.832-0.981,P<0.05)was a protective factor for mild OSA.Interaction analysis revealed that the risk of combination of two factors for developing mild OSA was 5.638,which exceeded that of high BMI(1.375)or vitamin D deficiency alone(2.216)(all P<0.05).Conclusion Vitamin D deficiency and overweight are risk factors for the development of mild OSA,and there is a positive interaction between these two factors.

关 键 词：维生素D缺乏 睡眠呼吸暂停 阻塞性 超重 

分 类 号：R76[医药卫生—耳鼻咽喉科]