Xin Xue, Zhe Zhao, Li-Bo Zhao, Ying-Hui Gao, Wei-Hao Xu, Wei-Meng Cai, Shao-Hua Chen, Tian-Jiao Li, Ting-Yu Nie, Dong Rui, Yao Ma, Xiao-Shun Qian, Jun-Ling Lin, Lin Liu
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引用次数: 0
摘要
背景：以往的研究表明，阻塞性睡眠呼吸暂停（OSA）与体弱之间存在明显的相关性。然而，平均脉搏氧饱和度（MSpO2）与 OSA 患者的虚弱程度之间的关系仍未得到证实。本研究旨在利用多中心、前瞻性队列的数据探讨这种潜在的关联：2015年1月至2017年10月期间，通过多导睡眠图（PSG）确诊为OSA的1006名老年患者被纳入研究。根据患者的MSpO2水平将其分为四组，以评估虚弱发病的差异。采用多变量 Cox 回归分析、Kaplan-Meier 曲线、限制性立方样条曲线和亚组分析来评估不同 MSpO2 水平下虚弱发病率的差异：中位随访期为 52 个月，275 名患者出现虚弱。使用限制性三次样条进行的分析显示，MSpO2 和虚弱风险之间呈 U 型趋势（非线性 p 值 = 0.028）。最低四分位数的患者（MSpO2 P = 0.029）与第三四分位数的患者（MSpO2 93-95%）相比。分组分析和敏感性分析证实了U形关系的稳健性：结论：MSpO2与OSA患者的虚弱程度呈U型关系。提高 MSpO2 水平可降低该人群的虚弱风险并改善预后。
U-Shaped Relationship Between MSpO2 Levels and the Incidence of Frailty in Elderly OSA Patients: Findings from a Multicenter Cohort Study.
Background: Previous studies have demonstrated a significant correlation between obstructive sleep apnea (OSA) and frailty. However, the association of mean pulse oxygen saturation (MSpO2) with frailty among OSA patients remains unconfirmed. This study aimed to explore this potential association using data from a multicenter, prospective cohort.
Methods: A total of 1006 elderly patients diagnosed with OSA through polysomnography (PSG) from January 2015 to October 2017 were enrolled. Patients were stratified into four groups according to their MSpO2 levels to assess differences in frailty onset. Multivariate Cox regression analysis, Kaplan-Meier curves, restricted cubic splines, and subgroup analyses were employed to evaluate variations in frailty onset across different MSpO2 levels.
Results: Over a median follow-up period of 52 months, 275 patients developed frailty. Analysis using restricted cubic splines revealed a U-shaped trend between MSpO2 and frailty risk (non-linear p-value = 0.028). Patients in the lowest quartile (MSpO2 < 91.6%) exhibited a higher risk of frailty (hazard ratio [HR] = 1.43, 95% confidence interval [CI] 1.03-1.97, P = 0.029) compared to those in the third quartile (MSpO2 93-95%). Subgroup and sensitivity analyses confirmed the robustness of the U-shaped relationship.
Conclusion: There is a U-shaped association between MSpO2 and frailty among patients with OSA. Enhancing MSpO2 levels may mitigate the risk of frailty and improve prognosis in this population.
期刊介绍：
Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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