阻塞性睡眠呼吸暂停综合征患者中肌少症患病率的meta分析

赵力博; 蔡伟梦; 赵哲; 何子君; 房凤凤; 刘霖; 范利

doi:10.16766/j.cnki.issn.1674-4152.003451

阻塞性睡眠呼吸暂停综合征患者中肌少症患病率的meta分析

doi: 10.16766/j.cnki.issn.1674-4152.003451

赵力博^{1, 2},
蔡伟梦¹,
赵哲¹,
何子君³,
房凤凤³,
刘霖^{2, 4},
范利^{2, 5, ,}

1.
解放军总医院研究生院，北京 100853
2.
解放军总医院国家老年疾病临床医学研究中心，北京 100853
3.
延安大学医学院，陕西延安 716000
4.
解放军总医院第二医学中心呼吸与危重症医学科，北京 100853
5.
解放军总医院第二医学中心心血管内科

基金项目:

军队保健专项科研课题 23BJZ27

军队保健专项科研课题 22BJZ52

军队装备建设应用研究项目 LB20211A010013

详细信息

通讯作者:
范利，E-mail: fl6698@163.com

中图分类号: R592 R563.9
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- 文章访问数: 260
- HTML全文浏览量: 116
- PDF下载量: 11
- 被引次数: 0
出版历程
- 收稿日期: 2023-05-04
- 网络出版日期: 2024-05-29

A meta-analysis of the prevalence of sarcopenia in patients with obstructive sleep apnea syndrome

ZHAO Libo^{1, 2},
CAI Weimeng¹,
ZHAO Zhe¹,
HE Zijun³,
FANG Fengfeng³,
LIU Lin^{2, 4},
FAN Li^{2, 5
, ,}

1.
Graduate School of Medical School of Chinese PLA, Beijing 100853, China

摘要

摘要: 目的分析阻塞性睡眠呼吸暂停综合征(OSAS)患者中肌少症的患病率，增强大众防病意识，做好肌少症防治。方法检索CNKI、万方、PubMed、Web of Science和Cochrane等数据库，搜集关于OSAS与肌少症的相关研究，时间范围为1994年—2023年1月28日。由2位研究者独立筛选文献、提取数据并评价纳入研究的质量，采用Stata 16统计学软件进行meta分析。结果共纳入9项研究，收集样本量合计2 815例，其中肌少症患者362例。Meta分析结果显示：OSAS患者中肌少症患病率为31.58%(95% CI：18.65%~44.50%)。以OSAS严重程度分组，中重度OSAS的肌少症患病率为43.81%(95% CI：12.66%~74.95%)，而轻中重度人群相应患病率为28.17%(95% CI：13.80%~42.54%)；不同年龄组间比较，40~60岁患者中肌少症患病率为17.89%(95% CI：8.15%~27.62%)，≥60岁老年患者的患病率明显升高[50.86%(95% CI：42.46%~59.25%)]。结论 OSAS患者中肌少症患病率较高，且在老年亚组中肌少症高发。做好肌少症防治，同时要重视对睡眠障碍的筛查与治疗。
- 阻塞性睡眠呼吸暂停综合征 /
- 肌少症 /
- 年龄 /
- 患病率 /
- Meta分析
Abstract: Objective To investigate the prevalence of sarcopenia in patients with obstructive sleep apnea syndrome (OSAS), to improve the awareness of the disease and aid in its prevention and treatment. Methods Relevant studies on OSAS and sarcopenia in patients were searched in the CNKI, Wanfang, PubMed, Web of Science and Cochrane databases from 1994 to January 28, 2023. Two researchers independently screened the literature, extracted data, and evaluated the quality of the included studies. Meta-analysis was performed using Stata 16. Results The analysis comprised nine studies, with a total of 2 815 patients diagnosed with OSAS, among whom 362 were diagnosed with sarcopenia. The meta-analysis revealed that the prevalence of sarcopenia in patients with OSAS was 31.58% (95% CI: 18.65% - 44.50%). The prevalence of sarcopenia in moderate to severe OSAS was 43.81% (95% CI: 12.66% - 74.95%), while the corresponding prevalence in mild to moderate to severe OSAS was 28.17% (95% CI: 13.80% - 42.54%). A subgroup analysis based on age revealed that the prevalence of sarcopenia was 17.89% (95% CI: 8.15% - 27.62%) in patients aged 40-60 years. The prevalence significantly increased in patients aged ≥ 60 years to 50.86% (95% CI: 42.46% - 59.25%). Conclusion The prevalence of sarcopenia was high in patients with OSAS, and this varied across different age groups. The prevalence of sarcopenia was higher in elderly patients aged 60 years or older. To effectively prevent and treat sarcopenia, it is important to focus on screening and treating sleep disorders. This will require increased attention to be paid to identifying and addressing sleep-related issues.
- Obstructive sleep apnea syndrome /
- Sarcopenia /
- Age /
- Prevalence /
- Meta-analysis

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图 1 文献筛选流程和结果

Figure 1. Process and results of literature screening

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图 2 OSAS患者中肌少症患病率森林图

Figure 2. Forest map of the prevalence of sarcopenia in patients with OSAS

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图 3 不同OSAS严重程度分组肌少症患病率的比较

Figure 3. Comparison of prevalence of sarcopenia in different OSAS severity

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图 4 发表偏倚检验的漏斗图

Figure 4. Funnel plot for publishing bias test

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图 5 OSAS患者中肌少症患病率的meta分析图(逐一剔除法)

Figure 5. Meta-analysis of the prevalence of sarcopenia in OSAS patients (one-by-one exclusion method)

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表 1 9篇OSAS患者中肌少症患病率文献基本情况和质量评分

Table 1. Basic information and quality scores of 9 literatures on the prevalence of sarcopenia in patients with OSAS

作者	地区	年龄 (岁)	OSAS严重程度^a	OSAS诊断	肌少症诊断	样本量 (例)	病例数 (例)	患病率 (%)	AHRQ评分
杜亭亭等^[9]	中国天津	65~85	轻中重	b	①+②	39	20	51.28	7
MONTI A等^[10]	法国巴黎	≥75	中重	b	①+②	28	17	60.71	6
ITO N等^[11]	日本大阪	≥65	轻中重	b	①+③	15	8	53.33	6
MATSUMOTO T等^[12]	日本京都	40~85	轻中重	b	③	322	83	25.78	6
MCFERRIN C A等^[13]	美国密苏里州	≥40	轻中重	b	①+④	113	26	23.01	8
		40~50				41	7	17.07
		50~60				37	9	24.32
		≥60				35	9	25.71
SOUZA H S等^[14]	巴西圣保罗	≥60	轻中重	b	①+②	52	23	44.23	7
PIOVEZAN R D等^[15]	巴西圣保罗	＞50	中重	b	①+②	186	54	29.03	9
SZLEJF C等^[16]	巴西圣保罗	≥50	轻中重	c	①+②	2 011	128	6.36	7
FERNANDES J F R等^[17]	巴西里约热内卢	45~80	轻中重	b	①+②	49	3	6.12	7
注：^a多导睡眠呼吸监测(polysomnography, PSG)是诊断OSAS的金标准^[18]，OSAS严重程度按照呼吸暂停低通气指数(apnea-hypopnea index, AHI)的大小分为轻度(5次/h≤AHI＜15次/h)、中度(15次/h≤AHI＜30次/h)和重度(AHI≥30次/h)；b为PSG，c为STOP-Bang量表；①肌肉力量，②肌肉质量，③运动机能表现，④SARC-F量表。

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表 2 亚组中OSAS患者的肌少症患病率情况

Table 2. Prevalence of sarcopenia in the subgroups of OSAS patients

亚组	纳入研究个数	异质性检验结果		患病率
亚组	纳入研究个数	I²(%)	P值 (95% CI)	患病率
全部研究	9^[9-17]	97.41	＜0.001	31.58%(18.65%~44.50%)
OSAS诊断标准
PSG金标准	8^{[9-15, 17]}	93.79	＜0.001	34.89%(22.10%~47.68%)
OSAS严重程度
中重度	2^{[10, 15]}	90.54	＜0.001	43.81%(12.66%~74.95%)
轻中重度	7^{[9, 11-14, 16, 17]}	97.44	＜0.001	28.17%(13.80%~42.54%)
地区
亚洲	3^{[9, 11, 12]}	81.27	＜0.001	41.08%(21.97%~60.19%)
北美、欧洲	2^{[10, 13]}	92.99	＜0.001	41.03%(3.94%~78.13%)
南美洲	4^[14-17]	97.51	＜0.001	20.72%(2.98%~38.46%)
年龄
40~60岁	5^{[12, 13, 15-17]}	95.60	＜0.001	17.89%(8.15%~27.62%)
≥60岁	4^{[9-11, 14]}	0.00	0.540	50.86%(42.46%~59.25%)

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