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中华临床医师杂志(电子版) ›› 2025, Vol. 19 ›› Issue (11) : 839 -847. doi: 10.3877/cma.j.issn.1674-0785.2025.11.007

临床研究

超重/肥胖青少年双相障碍患者的睡眠呼吸障碍与心血管风险特征及相关性分析
肖玉新, 阿衣加马力·衣马木, 热孜亚·艾合买提, 佟钙玉, 邹韶红()   
  1. 830001 乌鲁木齐,新疆维吾尔自治区人民医院临床心理科
  • 收稿日期:2025-10-14 出版日期:2025-11-30
  • 通信作者: 邹韶红
  • 基金资助:
    新疆维吾尔自治区自然科学基金资助项目(2022D01C606); 天山创新团队计划(2022D14011); 天山英才医药卫生领军人才培养项目(TSYC202401A004)

Sleep-related breathing disorders and cardiovascular risk profiles in adolescents with bipolar disorder: a correlation analysis stratified by overweight/obesity status

Yuxin Xiao, Gaiyu Tong, Shaohong Zou()   

  1. Department of Clinical Psychology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
  • Received:2025-10-14 Published:2025-11-30
  • Corresponding author: Shaohong Zou
引用本文:

肖玉新, 阿衣加马力·衣马木, 热孜亚·艾合买提, 佟钙玉, 邹韶红. 超重/肥胖青少年双相障碍患者的睡眠呼吸障碍与心血管风险特征及相关性分析[J/OL]. 中华临床医师杂志(电子版), 2025, 19(11): 839-847.

Yuxin Xiao, Gaiyu Tong, Shaohong Zou. Sleep-related breathing disorders and cardiovascular risk profiles in adolescents with bipolar disorder: a correlation analysis stratified by overweight/obesity status[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2025, 19(11): 839-847.

目的

探讨超重/肥胖对青少年双相情感障碍(BD)患者睡眠呼吸障碍、心血管风险特征及相关性的影响。

方法

采用横断面研究,纳入2024年6月至2025年6月新疆维吾尔自治区人民医院就诊的12~18岁BD患者44例,依据《学龄儿童青少年超重与肥胖筛查》标准,将患者分为BD超重/肥胖组(n=23)与BD体重正常组(n=21)。收集2组患者人口学资料、临床病程、采用整夜多导睡眠监测(PSG)获取客观睡眠参数,同步测量心血管指标,并采用匹兹堡睡眠质量指数(PSQI)评估主观睡眠质量,采用Logistic回归,Pearson和Spearman相关分析探讨相关因素。

结果

超重/肥胖组病程更长、收缩压更高、睡眠效率更低、阻塞性呼吸暂停低通气指数(OAHI)和主观睡眠质量评分均显著高于体重正常组(均P<0.05)。Logistic回归分析显示,睡眠效率(OR=0.867,95%CI:0.765~0.982)、OAHI(OR=1.374,95%CI:1.017~1.858)、收缩压(OR=1.190,95%CI:1.066~1.328)及睡眠质量评分(OR=2.280,95%CI:1.041~4.994)是超重/肥胖状态的影响因素,多因素分析进一步证实,睡眠效率(OR=0.826,95%CI:0.699~0.976,P=0.025)与收缩压(OR=1.254,95%CI:1.075~1.461,P=0.004)是超重/肥胖状态的独立预测因素。相关性分析提示,BMI与睡眠效率呈负相关(r=−0.334,P=0.027),OAHI(ρ=0.436,P=0.003)、收缩压(r=0.467,P<0.01)等呈正相关。

结论

超重/肥胖青少年BD患者存在更严重的睡眠呼吸障碍与心血管风险,睡眠效率与收缩压是体重状态的独立预测指标。临床实践中应重视对体重、睡眠及血压的综合管理,以改善患者预后。

Objective

To examine the effects of overweight/obesity on sleep-related breathing disorders, cardiovascular risk characteristics, and their interrelationships in adolescents with bipolar disorder (BD).

Methods

A cross-sectional study was conducted on 44 BD patients aged 12–18 years from the People's Hospital of Xinjiang Uygur Autonomous Region between June 2024 to June 2025. According to the Chinese screening standard for overweight and obesity in school-age children and adolescents, the patients were divided into an overweight/obesity BD group (n=23) and a normal-weight BD group (n=21). Demographic data, clinical course, and objective sleep parameters were collected via overnight polysomnography (PSG). Cardiovascular indicators were measured simultaneously. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression and Pearson and Spearman correlation analyses were employed to examine the related factors.

Results

The overweight/obesity group had a longer disease duration, higher systolic blood pressure (SBP), lower sleep efficiency (SE), and significantly higher obstructive apnea-hypopnea index (OAHI) and subjective sleep quality scores compared to the normal-weight group (all P<0.05). Logistic regression analysis indicated that SE (OR=0.867, 95%CI: 0.765~0.982), OAHI (OR=1.374, 95%CI: 1.017~1.858), SBP (OR=1.190, 95%CI: 1.066~1.328), and PSQI sleep quality score (OR=2.280, 95%CI: 1.041~4.994) were influencing factors for overweight/obesity status. Multivariate analysis further confirmed that SE (OR=0.826, 95%CI: 0.699~0.976, P=0.025) and SBP (OR=1.254, 95%CI: 1.075~1.461, P=0.004) were independent predictors of overweight/obesity status. Correlation analysis revealed that BMI was negatively correlated with SE (r=−0.334, P=0.027) and positively correlated with OAHI (ρ=0.436, P=0.003) and SBP (r =0.467, P<0.01).

Conclusion

Overweight/obese adolescents with BD exhibit more severe sleep-related breathing disorders and cardiovascular risks. Sleep efficiency and SBP are independent predictors of overweight/obesity status. Comprehensive management of body weight, sleep, and blood pressure should be emphasized in clinical practice to improve patient prognosis.

表1 超重/肥胖与体重正常青少年BD患者基线资料比较
项目分组 BD体重正常组(n=21) BD超重/肥胖组(n=23) 统计值 P
人口学资料
年龄(岁,
±s
15.8±2.5 16.4±1.7 t=-0.977 0.334
性别[例(%)] χ2=1.634 0.287
男性 3(14.3) 7(30.4)
女性 18(85.7) 16(69.6)
民族[例(%)] χ2=1.392 0.503
汉族 4(19.0) 8(34.8)
维吾尔族 10(47.6) 9(39.1)
其他民族 7(33.3) 6(26.1)
受教育年限[年,MQ1Q3)] 10(8,12) 11(9,12) U=197.500 0.292
临床特征
病程[月,MQ1Q3)] 12(6,24) 24(12,48) U=139.000 0.015
BMI(
±s
20.31±1.59 28.29±3.72 t=12.917 <0.001
PSG
TST(
±s
453.24±48.25 427.26±68.45 t=-1.442 0.157
SE [MQ1Q3)] 87.90(84.80,91.00) 83.90(78.80,87.90) U=134.500 0.012
SL [MQ1Q3)] 18.50(7.00,36.00) 30.00(11.00,46.50) U=187.500 0.204
WASO [MQ1Q3)] 35.50(29.50,50.00) 41.00(24.00,85.00) U=199.500 0.324
N1期[MQ1Q3)] 5.00(3.00,6.40) 4.90(3.60,8.90) U=213.000 0.503
N2期(
±s
67.01±8.61 65.60±7.82 t=-0.569 0.572
N3期(
±s
13.37±5.48 13.33±6.00 t=-0.024 0.981
REM期(
±s
15.03±5.57 14.63±5.91 t=-0.229 0.820
RL [MQ1Q3)] 196.50(96.00,271.50) 148.50(93.50,236.00) U=217.000 0.565
Min SpO2 [MQ1Q3)] 90.00(89.00,91.00) 89.00(85.00,90.00) U=191.500 0.233
呼吸暂停[MQ1Q3)] 2(0,8) 8(1,11) U=170.000 0.091
低通气[MQ1Q3)] 0(0,11) 14(1,35) U=149.500 0.027
OAHI [MQ1Q3)] 1.50(0.15,2.55) 3.40(0.30,9.90) U=149.000 0.029
心血管指标
Mean HR(
±s
74.0±10.0 75.0±11.0 t=0.144 0.887
Max HR [MQ1Q3)] 94(90,105) 104(96,110) U=158.500 0.051
Min HR [MQ1Q3)] 58(50,64) 58(46,64) U=214.500 0.525
SBP(
±s
108.0±9.0 118.0±6.0 t=4.411 <0.001
DBP [MQ1Q3)] 68(64,74) 74(70,77) U=158.000 0.050
匹兹堡睡眠量表
睡眠质量[MQ1Q3)] 2(2,2) 3(2,3) U=154.000 0.028
入睡时间[MQ1Q3)] 3(2,3) 3(2,3) U=226.000 0.664
睡眠时间[MQ1Q3)] 1(0,2) 1(0,2) U=218.000 0.567
主观睡眠效率[MQ1Q3)] 3(2,3) 3(1,3) U=214.500 0.459
睡眠障碍[MQ1Q3)] 2(2,2) 2(2,3) U=217.500 0.536
催眠药物[MQ1Q3)] 2(0,3) 2(0,3) U=227.500 0.726
日间功能障碍[MQ1Q3)] 3(3,3) 3(3,3) U=224.000 0.518
总分 14.0±3.0 15.0±4.0 t=0.724 0.473
表2 2组患者诊断OSA比较[例(%)]
表3 超重/肥胖状态影响因素的Logistic回归分析
表4 睡眠结构与生理指标的Pearson相关性分析
表5 具有统计学意义的 Spearman相关性分析结果
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