人体成分分析仪在筛查阻塞性睡眠呼吸暂停相关性高血压中的应用

周迟.人体成分分析仪在筛查阻塞性睡眠呼吸暂停相关性高血压中的应用[J].内科急危重症杂志,2024,30(5):397-400

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DOI：10.11768/nkjwzzzz.20240503

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基金项目:国家自然科学基金（81800336）

作者	单位	E-mail
周迟	华中科技大学同济医学院附属同济医院	jrtang@tjh.tjmu.edu.cn

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中文摘要:

摘要目的: 应用人体成分分析仪测定阻塞性睡眠呼吸暂停（OSA）相关性高血压与原发性高血压患者的人体成分，并探讨其与呼吸暂停低通气指数（AHI）的关系。方法:选取154例OSA相关性高血压患者（其中48例轻度、54例中度、52例重度）和51例原发性高血压患者为研究对象，采用人体成分分析仪测量其人体成分。结果:OSA相关性高血压患者的体重指数、体脂肪率、内脏脂肪面积（VFA）、腰围和上臂围度高于原发性高血压患者（P均<0.05）。其中VFA（r=0.726）和腰围（r=0.630）与AHI强正相关(P均<0.01)。以VFA>91.10 cm2筛查OSA相关性高血压的敏感度为61.7%，特异性为82.4%；以腰围>88.7 cm筛查OSA相关性高血压的敏感度为62.3%，特异性为78.4%。通过Logistic模型构建联合预测因子为-3.152+0.038×VFA+0.011×腰围，其筛查OSA相关性高血压的敏感度为82.1%，特异性为67.5%，截断值为1.105，受试者工作特征曲线下面积为0.795，诊断效能优于各项单独预测。结论:腹型肥胖是OSA相关性高血压发病的高危因素。采用人体成分分析仪，联合VFA和腰围对早期筛查OSA相关性高血压的高危人群具有重要意义。

英文摘要:

Abstract Objective: To investigate the body component in patients with obstructive sleep apnea (OSA)-related hypertension and primary hypertension by using body component analyzer, and explore its relationship with apnea-hypopnea index (AHI). Methods: A total of 154 patients with OSA-related hypertension (mild, n=48; moderate, n=54; severe, n=52) and 51 patients with primary hypertension were selected as the research objects. Body component analyzer was used to measure the human component data. Results: Patients with OSA-related hypertension had higher body mass index, percentage body fat, visceral fat area (VFA), waistline, and arm circumference than patients with primary hypertension (all P<0.05). The VFA (r=0.726) and waistline (r=0.630) were strongly and positively correlated with AHI (all P<0.01). The sensitivity and specificity of VFA >91.10 cm2 for screening OSA-related hypertension were 61.7% and 82.4% respectively. The sensitivity and specificity of waistline >88.7 cm for screening OSA-related hypertension were 62.3% and 78.4% respectively. The combined predictor constructed by Logistic was -3.152+0.038×VFA+0.011×waistline, which showed sensitivity was 82.1%, specificity was 67.5%, cutoff value was 1.105, and the area under ROC curve was 0.795. The diagnostic efficiency of combined predictor was better than that of single index prediction. Conclusion: Abdominal obesity is a high risk factor of OSA-related hypertension. By using body component analyzer, the combination of VFA and waistline is of great significance for early screening the high-risk population of OSA-related hypertension.