Risk Factors Analysis for Obstructive Sleep Apnea Combined with Metabolic Associated Fatty Liver Disease and Construction of Prediction Model
Objective To investigate clinical features and risk factors of obstructive sleep apnea(OSA)complicated with metabolic associated fatty liver disease(MAFLD),and to construct a prediction model,so as to provide reference for clinical diagnosis and treat-ment.Methods A total of 228 OSA patients admitted to Xiangyang No.1 People's Hospital Affiliate to Hubei University of Medicine from January 2020 to December 2022 were selected.According to whether complicated with MAFLD,the patients were divided into OSA+MAFLD group(n=94)and OSA group(n=134).According to the liver/spleen CT values,OSA+MAFLD group was further di-vided into OSA+mild MAFLD group(n=56)and OSA+moderate-severe MAFLD group(n=38).General clinical data,polysomnog-raphy(PSG),serological examination and other related indicators and parameters of all patients were collected for statistical analysis.Results Univariate analysis showed that there were significant differences between the OSA group and the OSA+MAFLD group in age,hypertension,diabetes,hyperlipidemia,body mass index(BMI),apnea hypopnea index(AHI),oxygen reduction index(ODI),lon-gest apnea time(LAT),snore frequency,lowest saturation oxygen(LSpO2),mean oxygen saturation(MSpO2),CT90％,fasting plasma glucose(FPG),alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyltransferase(GGT)(P＜0.05);and there were significant differences between the OSA+mild MAFLD group and the OSA+moderate-severe MAFLD group in age,hyperlip-idemia,BMI,AHI,ODI,LAT,snore frequency,LSpO2,MSpO2,CT90％and ALT(P＜0.05).Multivariate Logistic regression analy-sis showed that age,BMI,AHI,snore frequency were independent risk factors for OSA and MAFLD(P＜0.05);Age,BMI,AHI and ALT were independent risk factors for OSA with moderate-severe MAFLD(P＜0.05).The Logistic regression model was established:Y1=-13.183+0.083age+0.205BMI+0.039AHI+0.002snore frequency,the area under the receiver operating characteristic curve was 0.915,and the sensitivity and specificity of the regression model were 87.2％and 82.8％.Y2=-44.956+0.146age+0.510BMI+0.056AHI+0.022ALT,the area under the receiver operating characteristic curve was 0.924,and the sensitivity and specificity of the regression model were 78.9％and 91.1％.Conclusion In clinical work,the occurrence of MAFLD should be considered for OSA pa-tients with older age,higher BMI,higher AHI,and more snoring frequency.OSA patients with MAFLD with older age,higher BMI,higher AHI,and higher ALT are more serious.Moreover,the combined prediction model constructed in this study has better diagnostic value,and can provide reference for early diagnosis of OSA complicated with MAFLD.
Obstructive sleep apneaMetabolic associated fatty liver diseaseRisk factorsPrediction model
NETL
NSTL
万方数据
