传统与新型低氧血症相关指标用于阻塞性睡眠呼吸暂停严重程度及新发高血压：一项前瞻性队列研究
Conventional and novel hypoxemia-related indices for obstructive sleep apnea severity and incident hypertension: a prospective cohort study.
文献信息
| PMID | 42908617 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Lixia Wang |
| 作者单位 | Department of Pathology, West China Hospital, Sichuan University, Chengdu, China. |
| 期刊 | Frontiers in neurology |
| SCI 分区 | Q2 |
| IF | 3.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景与目的： 阻塞性睡眠呼吸暂停（OSA）与高血压（HTN）相关，但呼吸暂停低通气指数（AHI）和氧减饱和度指数（ODI）可能无法完全刻画与HTN发生相关的夜间低氧血症。我们评估了睡眠呼吸损害指数（SBII）和低氧负荷（HB）与新发HTN的关联，并将其判别性能与AHI和ODI进行比较。
方法： 这项前瞻性研究纳入来自睡眠心脏健康研究的601例基线无HTN的OSA参与者（AHI ≥ 15次/小时）。SBII、HB、AHI和ODI均按四分位数和连续变量进行分析。采用多变量logistic回归和限制性立方样条分析评估其与新发HTN的关联。通过比较临床基础模型与分别纳入各四分位数分类指标的模型来评估判别性能。
结果： 在中位随访约5年期间，194例（32.3%）参与者发生HTN。在主要完全校正模型中，SBII最高四分位数（OR，1.71；95% CI，1.02-2.90；p = 0.044）和HB最高四分位数（OR，1.69；95% CI，1.02-2.79；p = 0.041）与新发HTN的更高 odds 相关。在T90校正的敏感性模型中，两种关联均显著，而AHI和ODI四分位数仍不显著。临床基础模型的C统计量为0.614；加入SBII或HB并未显著改善判别能力。
结论： 探索性四分位数分析提示，在OSA参与者中，SBII和HB最高四分位数与新发HTN的更高 odds 相关，而AHI和ODI则不然。这些发现表明，SBII和HB的显著升高可能更全面地刻画与 incident HTN 相关的OSA夜间低氧血症。然而，连续变量和总体样条分析不显著以及增量判别能力有限，需谨慎解读并进一步验证。
英文摘要
BACKGROUND AND OBJECTIVE: Obstructive sleep apnea (OSA) is associated with hypertension (HTN), but the apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) may not fully characterize nocturnal hypoxemia relevant to HTN development. We evaluated the associations of the sleep breathing impairment index (SBII) and hypoxic burden (HB) with incident HTN and compared their discriminative performance with AHI and ODI.
METHODS: This prospective study included 601 participants with OSA (AHI ≥ 15 events/h) from Sleep Heart Health Study who were free of HTN at baseline. SBII, HB, AHI and ODI were analyzed both in quartiles and as continuous variables. Multivariable logistic regression and restricted cubic spline analyses were used to evaluate their associations with incident HTN. Discrimination performance was assessed by comparing a clinical base model with models that separately incorporating each quartile-categorized index.
RESULTS: During a median follow-up of approximately 5 years, 194 (32.3%) participants developed HTN. In the primary fully adjusted model, the highest quartiles of SBII (OR, 1.71; 95% CI, 1.02-2.90; p = 0.044) and HB (OR, 1.69; 95% CI, 1.02-2.79; p = 0.041) were associated with higher odds of incident HTN. In the T90-adjusted sensitivity model, both associations were significant, whereas AHI and ODI quartiles remained nonsignificant. The clinical base model had a C-statistic of 0.614; adding SBII or HB, did not significantly improve discrimination.
CONCLUSION: Exploratory quartile-based analyses suggested that the highest quartiles of SBII and HB were associated with higher odds of incident HTN among participants with OSA, whereas AHI and ODI were not. These findings indicate that marked elevation in SBII and HB may provide a more comprehensive characterization of OSA-related nocturnal hypoxemia relevant to incident HTN. However, the nonsignificant continuous and overall spline analyses and the limited incremental discrimination warrant cautious interpretation and further validation.