COMISA作为OSA患者白质高信号的独立相关因素：一项横断面研究及列线图构建

文献信息

中文摘要

背景： 阻塞性睡眠呼吸暂停（OSA）是脑小血管病中白质高信号（WMH）的公认危险因素。识别OSA患者WMH的危险因素对疾病管理很重要。
方法： 这项横断面研究（2021-2023）纳入OSA患者，收集PSG、MMSE和脑MRI数据。WMH根据STRIVE-2标准诊断。患者分为WMH组和非WMH组。通过组间比较和多因素logistic回归识别危险因素；构建列线图并通过ROC和校准曲线评估。
结果： 我们的发现提示，COMISA可能是所检查因素中WMH最强的独立相关因素。较高的BMI和增加的REM呼吸暂停-低通气指数与较高的WMH比值比独立相关，而较高的总蛋白和MMSE评分与较低的比值比相关。列线图显示出早期筛查的潜在效用，但需要外部验证。
结论： 在这项研究中，我们将COMISA确定为OSA患者WMH的独立危险因素。据我们所知，这是首批强调COMISA在此背景下作为潜在有价值预测因素的研究之一。这些发现可能为进一步的机制研究以及识别WMH高风险个体提供基础，可能为早期干预策略提供信息。

英文摘要

BACKGROUND: Obstructive sleep apnea (OSA) is a recognized risk factor for white matter hyperintensities (WMH) in cerebral small vessel disease. Identifying risk factors for WMH in OSA patients is important for disease management.
METHODS: This cross-sectional study (2021-2023) enrolled OSA patients and collected PSG, MMSE, and brain MRI data. WMH was diagnosed using STRIVE‑2 criteria. Patients were divided into WMH and non‑WMH groups. Risk factors were identified by between‑group comparisons and multivariate logistic regression; a nomogram was constructed and evaluated by ROC and calibration curves.
RESULTS: Our findings suggest that COMISA may be the strongest independent correlate of WMH among the factors examined. Higher BMI and increased REM apnea‑hypopnea index were independently associated with higher WMH odds, whereas higher total protein and MMSE scores were associated with lower odds. The nomogram showed potential utility for early screening, though external validation is needed.
CONCLUSION: In this study, we identified COMISA as an independent risk factor for WMH in patients with OSA. To our knowledge, this is among the first studies to highlight COMISA as a potentially valuable predictor in this context. These findings may offer a basis for further mechanistic investigations and for identifying individuals at higher risk of WMH, potentially informing early intervention strategies.