摘要
目的探讨住院患者阻塞性睡眠呼吸暂停低通气综合征(OSAHS)高患病风险和焦虑对糖尿病患病的影响及其交互作用。方法研究为横断面研究。选取2019年7月至2020年7月北京医院各科室住院患者,应用柏林问卷及广泛性焦虑量表分别评价其OSAHS风险及焦虑情况。应用χ^(2)检验、非参数检验比较不同血糖状态住院患者OSAHS风险及焦虑的差异,应用logistic回归模型分析二者对糖尿病患病的影响,并应用Delta方法计算二者对糖尿病患病交互作用的相关指标。结果1030例患者纳入研究,其中糖尿病组249例(24.1%)。在调整年龄、性别、吸烟饮酒情况、BMI及合并症情况等影响因素后,以OSAHS低风险为参照,OSAHS高风险对糖尿病患病影响的OR值为1.592(95%CI为1.155~2.196,P=0.005)。以无焦虑为参照,存在焦虑对糖尿病患病影响的OR值为1.531(95%CI为1.059~2.215,P=0.024)。调整混杂因素的影响后,OSAHS高风险与焦虑相乘对糖尿病患病的OR值为0.702(95%CI为0.344~1.433,P=0.331),两者对糖尿病无相乘交互作用。以OSAHS低风险且无焦虑为对照,OSAHS高风险但无焦虑对糖尿病患病的OR值为1.729(95%CI为1.205~2.482,P=0.003),OSAHS低风险但存在焦虑对糖尿病患病的OR值为1.794(95%CI为1.108~2.904,P=0.018),OSAHS高风险且存在焦虑对糖尿病患病的OR值为2.176(95%CI为1.299~3.646,P=0.003),较前两者单纯相加未见显著增高或降低,提示OSAHS风险及焦虑对糖尿病患病无显著相加交互作用。结论住院患者糖尿病患病率高,OSAHS高风险、焦虑均与住院患者罹患糖尿病独立相关,OSAHS风险与焦虑对糖尿病患病无相乘或相加交互作用。
Objective To analyze the effects of risk of obstructive sleep apnea hypopnea syndrome(OSAHS)and anxiety on diabetes mellitus(DM)and their interaction.Methods Inpatients in Beijing Hospital from July 2019 to July 2020 were include in the cross-sectional study.Berlin Questionnaire and Generalized Anxiety Scale were used to evaluate OSAHS risk and anxiety status of these inpatients.The chi-square test and non-parametric test were used to compare the difference of OSAHS risk and anxiety among inpatients with different blood glucose status.Logistic regression analysis was used to analyze the influence of OSAHS risk and anxiety on DM.Delta method was used to calculate the interaction between OSAHS risk and anxiety on DM.Results There were 1030 residents involved in the final analysis,among which the constituent ratio of DM was 24.1%.After adjusting for age,gender,body mass index(BMI),smoking and drinking history and complications,OSAHS risk(OR=1.592,95%CI 1.155-2.196,P=0.005)and anxiety(OR=1.531,95%CI 1.059-2.215,P=0.024)were independently associated with DM respectively.After adjusting for confounding factors,OR value of OSAHS risk multiplied by anxiety for diabetes was 0.702(95%CI 0.344-1.433,P=0.331).Compared with patients who had low risk of OSAHS and no anxiety symptoms,the risk of DM in those with high risk of OSAHS but without anxiety was 1.729(95%CI 1.205-2.482,P=0.003),and the risk of DM in those with low risk of OSAHS and anxiety was 1.794(95%CI 1.108-2.904,P=0.018).The risk of DM in those with high risk of OSAHS and anxiety was 2.176(95%CI 1.299-3.646,P=0.003).Conclusions The prevalence of DM in inpatients was high.The high risk of OSAHS and anxiety were independently related to DM,and there was no multiplicative or additive interaction between OSAHS risk and anxiety on DM.
作者
陈锦文
丁钐
潘琦
郭立新
Chen Jinwen;Ding Shan;Pan Qi;Guo Lixin(Department of Endocrinology,Beijing Hospital,National Center of Gerontology,Beijing 100730,China)
出处
《中华糖尿病杂志》
CAS
CSCD
北大核心
2022年第6期549-554,共6页
CHINESE JOURNAL OF DIABETES MELLITUS
