Association between preserved ratio impaired spirometry and sleep apnea in a Chinese community

Abstract

Objective

This study investigated the association between obstructive sleep apnea (OSA) and preserved ratio impaired spirometry (PRISm) in a community population.

Methods

Baseline data from a prospective cohort study, the Predictive Value of Combining Inflammatory Biomarkers and Rapid Decline of FEV1 for COPD (PIFCOPD), were used for cross-sectional analysis. Participants aged 40–75 years were recruited from the community and their demographic information and medical history were collected. The STOP-Bang questionnaire (SBQ) was used to assess the risk of OSA. Pulmonary function tests were performed using a portable spirometer (COPD-6) and forced expiratory volume in 1 s (FEV1) and 6 s (FEV6) were measured. Routine blood, biochemical, high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 tests were also performed. The pH of the exhaled breath condensate was determined.

Results

A total of 1183 participants were enrolled, of which 221 with PRISm and 962 with normal lung function. The neck circumference, waist-to-hip ratio, hs-CRP concentration, proportion of males, cigarette exposure, number of current smoker, high risk of OSA, and prevalence of nasal and ocular allergy symptoms were significantly higher in the PRISm group than in the non-PRISm group (p < .05). Logistic regression showed that the risk of OSA (odds ratio, 1.883; 95% confidence interval, 1.245–2.848), waist-to-hip ratio, current smoking, and prevalence of nasal allergy symptoms were independently associated with PRISm after correcting for age and sex.

Conclusion

These findings showed that OSA prevalence is independently associated with PRISm prevalence. Further studies should confirm the relationship between systemic inflammation in OSA, localized inflammation of the airways, and impaired lung function.

Keywords:

• Preserved ratio impaired spirometry
• sleep apnea
• inflammation

Transparency

Declaration of funding

This study was supported by a grant [2017YFC1309500] from the National Key Research and Development Plan sponsored by the Ministry of Science and Technology of the People’s Republic of China [2017YFC1309500], The Beijing Municipal Science & Technology Commission-Capital Characteristic Clinic Project [Z221100007422040], and the National Natural Science Foundation of China [Grant Number:82000096].

Declaration of financial/other relationships

The authors report no conflicts of interest associated with this work.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Cheng Zhang and Shanshan Wei contributed equally to this work and was the co-first author of the manuscript. Cheng Zhang was involved throughout the project, including subject recruitment, enrollment, questionnaire completion, organizational coordination, data analysis, and manuscript writing. Shanshan Wei had the idea for and designed this paper, and was involved throughout the project, including subject screening and recruitment, questionnaire survey, and data cleansing, wrangling and scaling. Yunxia Wang was involved in subject enrollment, questionnaire completion, and processing of blood samples, and Kunyao Yu was involved in statistical analysis of the data.

Zhe Jin, Meng Zhang, Xiaoyu Ma, Chunbo Zhang, Qi Zhang, Kunyan Sun, Peining Zhou, and Yijue Zhong were involved in the screening of subjects, questionnaires, pulmonary function tests, and the separation and preservation of blood samples for testing. Qi Zhang and Kunyan Sun also performed an ELISA assay for serum IL-6 levels. Jing Ma was involved in subject recruitment, organization, and implementation as well as the selection and training of sleep screening scales. Jiping Liao conceived the study and was responsible for the organization and implementation of the entire project. Guangfa Wang conceived and designed the study and was the PI of the project and responsible for the design and advancement of the project.

Acknowledgements

None stated.