The Risk Factors and Predictors of Chronic Obstructive Pulmonary Disease in Patients With Obstructive Sleep Apnea–Hypopnea Syndrome at Plateau

ABSTRACT Background OSAHS patients with COPD (i.e., overlap syndrome) have a significantly worse prognosis than those with OSAHS alone, and the role of plateau hypoxia in the occurrence of the disease is still unclear. This underscores the urgent need to explore the risk factors for the incidence of...

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Main Authors: Yumei Geng, Yu Hu, Bin Li, Zhuoma Dawa, Fang Zhang
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:The Clinical Respiratory Journal
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Online Access:https://doi.org/10.1111/crj.70053
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author Yumei Geng
Yu Hu
Bin Li
Zhuoma Dawa
Fang Zhang
author_facet Yumei Geng
Yu Hu
Bin Li
Zhuoma Dawa
Fang Zhang
author_sort Yumei Geng
collection DOAJ
description ABSTRACT Background OSAHS patients with COPD (i.e., overlap syndrome) have a significantly worse prognosis than those with OSAHS alone, and the role of plateau hypoxia in the occurrence of the disease is still unclear. This underscores the urgent need to explore the risk factors for the incidence of COPD in patients with OSAHS and to identify predictors for the occurrence of overlap syndrome at plateau. Methods Fifty patients with OSAHS and 34 patients with overlap syndrome were enrolled in this study. Demographic, auxiliary examination, and laboratory data were collected. Results All patients enrolled were obstructive sleep apnea–hypopnea syndrome. The apnea–hypopnea index (AHI), the number of hypopnea, and the oxygen desaturation index were higher in the group of patients with overlap syndrome than in the group of patients with OSAHS. The mean pulse oxygen saturation was lower than that in the group of patients with OSAHS (p < 0.05). The right heart structure and function indexes (PASP, right atrial transverse diameter, RVTD, BNP, TNI) in patients with overlap syndrome were worse than those in patients with OSAHS (p < 0.05), and this worse cardiovascular status was positively correlated with inflammatory factors such as high‐sensitivity C‐reactive protein, IL‐6, and PCT (p < 0.05). Binary logistic regression analysis indicated that PASP, smoking index, and AHI were independent risk factors for OSAHS developing into overlap syndrome. ROC curve showed that the area under the curve of the combination of the three markers for predicting overlap syndrome was 0.908 (95% CI 0.843–0.974, p = 0.000), with a sensitivity of 0.882 and a specificity of 0.820. The optimal cutoff values for PASP were 42.5 mmHg, 15 for the smoking index, and 25.65 for the AHI based on the Youden index. Conclusions Our study reveals that overlap syndrome has more frequent nighttime hypopnea and hypoxia than OSAHS alone. The cardiovascular complications of overlapping syndromes at plateau are more pronounced, possibly due to the exacerbation of the systemic inflammatory response. The combination of PASP, smoking index, and AHI can be a powerful tool for predicting and assessing the occurrence of COPD in OSAHS patients from plateau populations in China. These findings have the potential to significantly improve the management and prognosis of patients with overlap syndrome.
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spelling doaj-art-bec95caac3b64f0db7b019edc3fd69b92025-08-20T02:45:38ZengWileyThe Clinical Respiratory Journal1752-69811752-699X2025-02-01192n/an/a10.1111/crj.70053The Risk Factors and Predictors of Chronic Obstructive Pulmonary Disease in Patients With Obstructive Sleep Apnea–Hypopnea Syndrome at PlateauYumei Geng0Yu Hu1Bin Li2Zhuoma Dawa3Fang Zhang4Department of Respiratory and Critical Care Medicine Qinghai Provincial People's Hospital Xining ChinaDepartment of Pharmacy Qinghai Provincial Traffic Hospital Xining ChinaQinghai Institute of Health Sciences Xining ChinaDepartment of Science and Education Qinghai Provincial People's Hospital Xining ChinaDepartment of Respiratory and Critical Care Medicine Qinghai Provincial People's Hospital Xining ChinaABSTRACT Background OSAHS patients with COPD (i.e., overlap syndrome) have a significantly worse prognosis than those with OSAHS alone, and the role of plateau hypoxia in the occurrence of the disease is still unclear. This underscores the urgent need to explore the risk factors for the incidence of COPD in patients with OSAHS and to identify predictors for the occurrence of overlap syndrome at plateau. Methods Fifty patients with OSAHS and 34 patients with overlap syndrome were enrolled in this study. Demographic, auxiliary examination, and laboratory data were collected. Results All patients enrolled were obstructive sleep apnea–hypopnea syndrome. The apnea–hypopnea index (AHI), the number of hypopnea, and the oxygen desaturation index were higher in the group of patients with overlap syndrome than in the group of patients with OSAHS. The mean pulse oxygen saturation was lower than that in the group of patients with OSAHS (p < 0.05). The right heart structure and function indexes (PASP, right atrial transverse diameter, RVTD, BNP, TNI) in patients with overlap syndrome were worse than those in patients with OSAHS (p < 0.05), and this worse cardiovascular status was positively correlated with inflammatory factors such as high‐sensitivity C‐reactive protein, IL‐6, and PCT (p < 0.05). Binary logistic regression analysis indicated that PASP, smoking index, and AHI were independent risk factors for OSAHS developing into overlap syndrome. ROC curve showed that the area under the curve of the combination of the three markers for predicting overlap syndrome was 0.908 (95% CI 0.843–0.974, p = 0.000), with a sensitivity of 0.882 and a specificity of 0.820. The optimal cutoff values for PASP were 42.5 mmHg, 15 for the smoking index, and 25.65 for the AHI based on the Youden index. Conclusions Our study reveals that overlap syndrome has more frequent nighttime hypopnea and hypoxia than OSAHS alone. The cardiovascular complications of overlapping syndromes at plateau are more pronounced, possibly due to the exacerbation of the systemic inflammatory response. The combination of PASP, smoking index, and AHI can be a powerful tool for predicting and assessing the occurrence of COPD in OSAHS patients from plateau populations in China. These findings have the potential to significantly improve the management and prognosis of patients with overlap syndrome.https://doi.org/10.1111/crj.70053COPDOSAHSplateaurisk factors
spellingShingle Yumei Geng
Yu Hu
Bin Li
Zhuoma Dawa
Fang Zhang
The Risk Factors and Predictors of Chronic Obstructive Pulmonary Disease in Patients With Obstructive Sleep Apnea–Hypopnea Syndrome at Plateau
The Clinical Respiratory Journal
COPD
OSAHS
plateau
risk factors
title The Risk Factors and Predictors of Chronic Obstructive Pulmonary Disease in Patients With Obstructive Sleep Apnea–Hypopnea Syndrome at Plateau
title_full The Risk Factors and Predictors of Chronic Obstructive Pulmonary Disease in Patients With Obstructive Sleep Apnea–Hypopnea Syndrome at Plateau
title_fullStr The Risk Factors and Predictors of Chronic Obstructive Pulmonary Disease in Patients With Obstructive Sleep Apnea–Hypopnea Syndrome at Plateau
title_full_unstemmed The Risk Factors and Predictors of Chronic Obstructive Pulmonary Disease in Patients With Obstructive Sleep Apnea–Hypopnea Syndrome at Plateau
title_short The Risk Factors and Predictors of Chronic Obstructive Pulmonary Disease in Patients With Obstructive Sleep Apnea–Hypopnea Syndrome at Plateau
title_sort risk factors and predictors of chronic obstructive pulmonary disease in patients with obstructive sleep apnea hypopnea syndrome at plateau
topic COPD
OSAHS
plateau
risk factors
url https://doi.org/10.1111/crj.70053
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