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Predictors of Obstructive Sleep Apnea Risk among Blacks with Metabolic Syndrome. 黑人代谢综合征患者阻塞性睡眠呼吸暂停风险的预测因素

Journal of Obesity and Overweight

Pub Date : 2015-05-27 DOI: 10.15744/2455-7633.1.104

A. Rogers, J. Ravenell, M. Donat, A. Sexias, C. Ogedegbe, Samy I McFarlane, G. Jean-Louis

INTRODUCTIONIdentification of risk factors for obstructive sleep apnea (OSA) is important to enable comprehensive intervention to reduce OSA-related cardiovascular disease (CVD). The metabolic syndrome outcome study (MetSO) provides a unique opportunity to address these factors. This study investigated risk of OSA among blacks with metabolic syndrome.METHODSThe present study utilized data from MetSO, an NIH-funded cohort study of blacks with metabolic syndrome. A total of 1,035 patients provided data for the analysis. These included sociodemographic factors, health risks, and medical history. Physician-diagnosed conditions were obtained using an electronic medical record system (Allscripts, Sunrise Enterprise). Patients were diagnosed with metabolic syndrome using criteria articulated in the joint interim statement for harmonizing the metabolic syndrome. Patients with a score ≥6 on the Apnea Risk Evaluation System (ARES) questionnaire were considered at risk for OSA. Obesity is defined by body mass index (BMI ≥ 30 kg/m2).RESULTSOf the 1,035 patients screened in the MetSO cohort, 48.9% were at high risk for OSA. Using multivariate-adjusted logistic regression analysis, we observed that obesity was the strongest predictor of OSA risk (OR=1.59, 95%CI=1.24-2.04, p<0.0001). This finding remained significant even after adjustment for known covariates including blood pressure, low-density lipoprotein, high-density lipoprotein, and glucose levels (OR=1.44, 95%CI=1.11-1.86, p<0.001).CONCLUSIONBlacks in the MetSO cohort are at greater OSA risk, relative to the adult population in developed countries. Consistent with previous observations, obesity proved the strongest independent predictor of OSA risk among blacks with metabolic syndrome.

识别阻塞性睡眠呼吸暂停(OSA)的危险因素对于进行综合干预以减少OSA相关心血管疾病(CVD)非常重要。代谢综合征结局研究(MetSO)提供了一个独特的机会来解决这些因素。本研究调查了代谢综合征黑人患阻塞性睡眠呼吸暂停的风险。方法本研究采用MetSO的数据，这是一项由美国国立卫生研究院资助的黑人代谢综合征队列研究。共有1035名患者为分析提供了数据。这些因素包括社会人口因素、健康风险和病史。使用电子病历系统(Allscripts, Sunrise Enterprise)获得医生诊断的病情。患者被诊断为代谢综合征使用在联合临时声明中阐明的标准，以协调代谢综合征。呼吸暂停风险评估系统(ARES)问卷得分≥6分的患者被认为存在OSA风险。肥胖的定义是体重指数(BMI≥30 kg/m2)。结果在MetSO队列中筛选的1035例患者中，48.9%的患者存在OSA高风险。通过多因素调整logistic回归分析，我们发现肥胖是OSA风险的最强预测因子(OR=1.59, 95%CI=1.24-2.04, p<0.0001)。即使校正了已知协变量，包括血压、低密度脂蛋白、高密度脂蛋白和血糖水平，这一发现仍然具有显著意义(OR=1.44, 95%CI=1.11-1.86, p<0.001)。结论:与发达国家的成年人相比，MetSO队列中的黑人患OSA的风险更高。与先前的观察结果一致，肥胖被证明是代谢综合征黑人中OSA风险的最强独立预测因子。

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引用次数: 12

Objectively coding intervention fidelity during a phone-based obesity prevention study. 在一项基于手机的肥胖预防研究中，客观编码干预保真度。

Journal of Obesity and Overweight

Pub Date : 2015-05-26 DOI: 10.15744/2455-7633.1.102

Meghan M. JaKa, Elisabeth M. Seburg, Alison M. Roeder, N. Sherwood

BACKGROUNDChildhood obesity prevention studies have yielded disappointing results. Understanding intervention fidelity is necessary in explaining why interventions are (or are not) successful and ultimately improving future intervention. In spite of this, intervention fidelity it is not consistently reported in the obesity prevention literature. The purpose of the current study was to develop and utilize a coding protocol to objectively assess intervention fidelity in a phone-based obesity prevention study for parents of preschool-aged children.FINDINGSBoth interventionists and independent coders completed session fidelity measures including time spent on target areas (media use, physical activity, etc.) and components of goal setting quality. Coders also rated participant engagement. Agreement between ratings by interventionists and coders, fidelity levels and changes in fidelity components over time are presented. Coders and interventionists showed high agreement when reporting time spent discussing different target areas. Interventionists consistently rated themselves higher than independent coders on measures of goal quality. Coder ratings of session quality were initially high, but some components declined slightly across the eight sessions.CONCLUSIONSFuture directions for intervention fidelity measurement and analysis are discussed, including utilizing changes in fidelity measures over time to predict study outcomes. Obtaining a more in-depth understanding of intervention fidelity has the potential to strengthen obesity interventions.

儿童肥胖预防研究的结果令人失望。理解干预的保真度对于解释干预为何成功(或不成功)并最终改善未来的干预是必要的。尽管如此，干预保真度在肥胖预防文献中并没有一致的报道。本研究的目的是开发和利用编码协议来客观评估学龄前儿童父母基于手机的肥胖预防研究中的干预保真度。研究结果:干预者和独立编码员都完成了会话保真度测量，包括在目标区域(媒体使用、身体活动等)花费的时间和目标设定质量的组成部分。编码员还评估了参与者的参与度。干预主义者和编码员的评分、保真度水平和保真度成分随时间的变化之间的一致性。编码人员和干预主义者在报告讨论不同目标领域所花费的时间时表现出高度一致。在目标质量方面，干预主义者始终认为自己比独立程序员更高。编码员对会话质量的评分最初很高，但在8个会话中，一些组件略有下降。结论讨论了干预保真度测量和分析的未来方向，包括利用保真度随时间的变化来预测研究结果。获得对干预保真度的更深入了解有可能加强肥胖干预。

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引用次数: 4

Objectively coding intervention fidelity during a phone-based obesity prevention study. 在一项基于电话的肥胖预防研究中，对干预的忠实性进行客观编码。

Journal of Obesity and Overweight

Pub Date : 2015-01-01 Epub Date: 2015-05-26

Meghan M JaKa, Elisabeth M Seburg, Alison M Roeder, Nancy E Sherwood

Background: Childhood obesity prevention studies have yielded disappointing results. Understanding intervention fidelity is necessary in explaining why interventions are (or are not) successful and ultimately improving future intervention. In spite of this, intervention fidelity it is not consistently reported in the obesity prevention literature. The purpose of the current study was to develop and utilize a coding protocol to objectively assess intervention fidelity in a phone-based obesity prevention study for parents of preschool-aged children.

Findings: Both interventionists and independent coders completed session fidelity measures including time spent on target areas (media use, physical activity, etc.) and components of goal setting quality. Coders also rated participant engagement. Agreement between ratings by interventionists and coders, fidelity levels and changes in fidelity components over time are presented. Coders and interventionists showed high agreement when reporting time spent discussing different target areas. Interventionists consistently rated themselves higher than independent coders on measures of goal quality. Coder ratings of session quality were initially high, but some components declined slightly across the eight sessions.

Conclusions: Future directions for intervention fidelity measurement and analysis are discussed, including utilizing changes in fidelity measures over time to predict study outcomes. Obtaining a more in-depth understanding of intervention fidelity has the potential to strengthen obesity interventions.

背景：儿童肥胖预防研究的结果令人失望。了解干预措施的忠实性对于解释干预措施成功（或失败）的原因以及最终改进未来的干预措施非常必要。尽管如此，肥胖预防文献中并没有持续报告干预的忠实性。本研究的目的是制定并使用编码协议，以客观评估针对学龄前儿童家长的电话肥胖预防研究中干预的忠实性：干预者和独立编码员都完成了会话保真度测量，包括目标领域（媒体使用、体育活动等）所花费的时间和目标设定质量的组成部分。编码员还对参与者的参与度进行了评分。表中列出了干预者和编码者评分之间的一致性、忠实度水平以及忠实度组成部分随时间的变化。在报告讨论不同目标领域所花费的时间时，编码者和干预者表现出高度一致。在目标质量方面，干预者对自己的评分一直高于独立编码者。编码者对疗程质量的评分最初很高，但在八个疗程中，某些部分的评分略有下降：讨论了干预忠实度测量和分析的未来方向，包括利用忠实度测量随时间的变化来预测研究结果。更深入地了解干预的忠实度有可能加强肥胖干预。

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引用次数: 0

Predictors of Obstructive Sleep Apnea Risk among Blacks with Metabolic Syndrome. 患有代谢综合征的黑人中阻塞性睡眠呼吸暂停风险的预测因素。

Journal of Obesity and Overweight

Pub Date : 2015-01-01 Epub Date: 2015-05-27

A Rogers, J Ravenell, M Donat, A Sexias, C Ogedegbe, S I McFarlane, G Jean-Louis

Introduction: Identification of risk factors for obstructive sleep apnea (OSA) is important to enable comprehensive intervention to reduce OSA-related cardiovascular disease (CVD). The metabolic syndrome outcome study (MetSO) provides a unique opportunity to address these factors. This study investigated risk of OSA among blacks with metabolic syndrome.

Methods: The present study utilized data from MetSO, an NIH-funded cohort study of blacks with metabolic syndrome. A total of 1,035 patients provided data for the analysis. These included sociodemographic factors, health risks, and medical history. Physician-diagnosed conditions were obtained using an electronic medical record system (Allscripts, Sunrise Enterprise). Patients were diagnosed with metabolic syndrome using criteria articulated in the joint interim statement for harmonizing the metabolic syndrome. Patients with a score ≥6 on the Apnea Risk Evaluation System (ARES) questionnaire were considered at risk for OSA. Obesity is defined by body mass index (BMI ≥ 30 kg/m²).

Results: Of the 1,035 patients screened in the MetSO cohort, 48.9% were at high risk for OSA. Using multivariate-adjusted logistic regression analysis, we observed that obesity was the strongest predictor of OSA risk (OR=1.59, 95%CI=1.24-2.04, p<0.0001). This finding remained significant even after adjustment for known covariates including blood pressure, low-density lipoprotein, high-density lipoprotein, and glucose levels (OR=1.44, 95%CI=1.11-1.86, p<0.001).

Conclusion: Blacks in the MetSO cohort are at greater OSA risk, relative to the adult population in developed countries. Consistent with previous observations, obesity proved the strongest independent predictor of OSA risk among blacks with metabolic syndrome.

导言：识别阻塞性睡眠呼吸暂停（OSA）的风险因素对于采取综合干预措施以减少与 OSA 相关的心血管疾病（CVD）非常重要。代谢综合征结果研究（MetSO）为解决这些因素提供了一个独特的机会。本研究调查了患有代谢综合征的黑人患 OSA 的风险：本研究利用了由美国国立卫生研究院（NIH）资助的代谢综合征黑人队列研究 MetSO 的数据。共有 1,035 名患者为分析提供了数据。这些数据包括社会人口因素、健康风险和病史。医生诊断的病情是通过电子病历系统（Allscripts，Sunrise Enterprise）获得的。采用协调代谢综合征联合临时声明中阐述的标准诊断患者是否患有代谢综合征。呼吸暂停风险评估系统 (ARES) 问卷得分≥6 分的患者被视为有 OSA 风险。肥胖的定义是体重指数（BMI ≥ 30 kg/m2）：在 MetSO 队列筛查的 1,035 名患者中，48.9% 属于 OSA 高危人群。通过多变量调整逻辑回归分析，我们发现肥胖是 OSA 风险的最强预测因子（OR=1.59，95%CI=1.24-2.04，p）：与发达国家的成年人相比，MetSO队列中的黑人面临更大的OSA风险。与之前的观察结果一致，在患有代谢综合征的黑人中，肥胖是预测 OSA 风险的最强独立因素。

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引用次数: 0

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