Correlation between body mass index and severity of obstructive sleep apnea hypopnea syndrome in the elderly
Received:October 30, 2020  
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DOI:10.11915/j.issn.1671-5403.2021.04.054
Key words:aged  body mass index  obstructive sleep apnea hypopnea syndrome  correlation This work was supported by the Special Research Fund for Military Health Care
Author NameAffiliationE-mail
ZHAO Li-Bo Team 1, Graduate School,
Department of Cardiology of Second Medical Center,
National Clinical Research Center for Geriatric Diseases, 
liulin715@qq.comcorrelation 
XU Wei-Hao Hainan Retired Cadre′s Sanitarium of Hainan Military Region, Haikou 570100, China liulin715@qq.comcorrelation 
FAN Li Department of Cardiology of Second Medical Center,
National Clinical Research Center for Geriatric Diseases, 
liulin715@qq.comcorrelation 
QIAN Xiao-Shun National Clinical Research Center for Geriatric Diseases,
Department of Respiratory and Critical Care Medicine of Second Medical Center, 
liulin715@qq.comcorrelation 
GAO Ying-Hui PKU-UPenn Sleep Center, Peking University International Hospital, Beijing 102206, China liulin715@qq.comcorrelation 
XU Hu Department of Cardiology of Second Medical Center, liulin715@qq.comcorrelation 
KONG Xiao-Xuan Department of Cardiology of Second Medical Center, liulin715@qq.comcorrelation 
CHE He-Bin Big Data Center, Medical Innovation Research Division, Chinese PLA General Hospital, Beijing 100853, China liulin715@qq.comcorrelation 
WANG Ya-Bin National Clinical Research Center for Geriatric Diseases, liulin715@qq.comcorrelation 
CHEN Kai-Bing Department of Sleep Disorders, Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Lanzhou 730000, China liulin715@qq.comcorrelation 
LIU Lin National Clinical Research Center for Geriatric Diseases,
Department of Respiratory and Critical Care Medicine of Second Medical Center, 
liulin715@qq.comcorrelation 
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Abstract:
      Objective To investigate the correlation of body mass index (BMI) with the severity of obstructive sleep apnea hypopnea syndrome (OSAHS) in the elderly. Methods The medical records of 609 elderly patients (≥60 years old) suffering from OSAHS diagnosed by standard polysomnography in Chinese PLA General Hospital, Peking University International Hospital and the Affiliated Hospital of Gansu University of Traditional Chinese Medicine from January 2015 to October 2017 were collected and analyzed retrospectively. The subjects were divided into the normal weight (n=154), overweight (n=228) and obese (n=227) groups according to their different levels of BMI. The main indicators of polysomnography were compared among the three groups. SPSS statistics 25.0 was used for data analysis. Spearman rank correlation analysis was used to study the correlation between BMI and these main indicators, and multivariate logistic regression analysis was applied to explore the correlation between different BMI levels and OSAHS severity in the elderly. Results There were no significant differences in levels of apnea hypopnea index (AHI), time of oxygen saturation(SaO2)<90%, oxygen desaturation index (ODI) , mean pause time, lowest oxygen saturation, mean oxygen saturation and percentage of the times for SaO2 <90% in total monitoring time during overnight sleep (T90) among the 3 groups (P<0.05). BMI was positively correlated with AHI, maximum pause time, ODI, T90 and time of SpO2<90% (r=0.294,0.113,0.313,0.413,0.411, all P<0.05), but negatively correlated with mean oxygen saturation and minimum oxygen saturation in the elderly OSAHS patients (r=-0.173, -0.229, all P<0.05). The risk of severe OSAHS in the overweight group was 1.690 times higher than that of the normal weight group (OR=1.690), and the risk was even higher in the obese group (OR=3.685). A stratified analysis between the hypertension and non-hypertension subjects found that the correlation between obesity and severe OSAHS existed in both hypertensive and non-hypertensive subgroups, and the correlation between obesity and severe OSAHS was greater in non-hypertensive subjects. Conclusion In the elderly, the greater BMI is, the more severe OSAHS is. The correlation between BMI and severity of OSAHS is stronger for the non-hypertensive elderly people.
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