阻塞性睡眠呼吸暂停与保留比值受损肺功能对心血管结局的联合影响
Combined Effect of Obstructive Sleep Apnea and Preserved Ratio Impaired Spirometry on Cardiovascular Outcomes.
文献信息
| PMID | 42857998 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Lida Chen |
| 作者单位 | Department of Cardiovascular Diseases Mayo Clinic Rochester MN USA. |
| 期刊 | Journal of the American Heart Association |
| SCI 分区 | Q1 |
| IF | 6.2 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 阻塞性睡眠呼吸暂停（OSA）与慢性阻塞性肺疾病重叠综合征已被认为与更差的心血管结局相关。保留比值受损肺功能（PRISm）被认为是慢性阻塞性肺疾病的早期阶段。然而，OSA与PRISm共存是否增加心血管风险仍不清楚。
方法： 利用睡眠心脏健康研究的数据，参与者根据OSA和PRISm状态被分为4组。主要结局是主要不良心脑血管事件。次要结局是心血管疾病死亡率。使用多变量Cox回归模型评估这些组与心血管结局风险的关联。
结果： 在中位随访11.45年期间，主要不良心脑血管事件的发生率在非OSA且肺功能正常组为17.00%，非OSA伴PRISm组为27.52%，OSA且肺功能正常组为25.28%，OSA伴PRISm组为49.40%。经过多变量调整后，与非OSA且肺功能正常组相比，主要不良心脑血管事件的调整风险比（HR）在非OSA伴PRISm组为1.20（95% CI，0.82-1.75），OSA且肺功能正常组为1.04（95% CI，0.89-1.21），OSA伴PRISm组为1.52（95% CI，1.08-2.12）。相应的CVD死亡率HR分别为2.02（95% CI，1.26-3.24）、1.05（95% CI，0.81-1.35）和2.17（95% CI，1.41-3.34）。观察到显著的性别交互作用（交互作用P=0.009），该关联仅存在于女性中。
结论： OSA与PRISm共存与不良心血管结局风险增加独立相关。这种关联主要在女性中观察到。
英文摘要
BACKGROUND: Obstructive sleep apnea (OSA)-chronic obstructive pulmonary disease overlap syndrome has been linked to worse cardiovascular outcomes. Preserved ratio impaired spirometry (PRISm) is recognized as an early stage of chronic obstructive pulmonary diseas. However, whether the coexistence of OSA and PRISm confers increased cardiovascular risk remains unknown.
METHODS: Using data from the Sleep Heart Health Study, participants were categorized into 4 groups according to OSA and PRISm status. The primary outcome was major adverse cardiovascular and cerebrovascular events. The secondary outcome was cardiovascular disease mortality. Multivariable Cox regression models were used to evaluate the association of these groups with the risk of cardiovascular outcomes.
RESULTS: During a median follow-up of 11.45 years, the incidence of major adverse cardiovascular and cerebrovascular events was 17.00% in non-OSA with normal lung function, 27.52% in non-OSA with PRISm, 25.28% in OSA with normal lung function, and 49.40% in OSA with PRISm. After multivariable adjustment, compared with non-OSA with normal lung function, the adjusted hazard ratios (HRs) for major adverse cardiovascular and cerebrovascular events were 1.20 (95% CI, 0.82-1.75) in non-OSA with PRISm, 1.04 (95% CI, 0.89-1.21) in OSA with normal lung function, and 1.52 (95% CI, 1.08-2.12) in OSA with PRISm. Corresponding HRs for CVD mortality were 2.02 (95% CI, 1.26-3.24), 1.05 (95% CI, 0.81-1.35), and 2.17 (95% CI, 1.41-3.34), respectively. A significant sex interaction was observed (P for interaction=0.009), with the association present only in women.
CONCLUSIONS: The coexistence of OSA and PRISm is independently associated with increased risk of adverse cardiovascular outcomes. This association is observed predominantly in women.