Effects of abdominal obesity on cognitive status in patients with moderate to severe of obstructive sleep apnea syndrome / 中华老年医学杂志

ABSTRACT

Objective:To observe the effects of abdominal obesity on cognitive status in patients with obstructive sleep apnea syndrome(OSAS).Methods:150 cases with moderate to severe OSAS patients were enrolled in this prospective case-control study in the Department of Neurology of Beijing Luhe Hospital Affiliated to Capital Medical University from June 2016 to September 2020.According to whether abdominal obesity was complicated, the patients were divided into non-abdominal obesity group(n=31)and abdominal obesity group(n=119). The cognitive function of the patients was evaluated by Montreal Cognitive Assessment(Mo-CA)scale and Symbol Digit Modalities Test(SDMT)in the two groups, and the independent influencing factors of each cognitive function were determined by linear regression.Two factors Analysis of Variance(ANOVA)was used to analyze the main effects and interactions of Apnea Hypopnea Index(AHI)and abdominal obesity on various cognitive functions.Results:Compared with the non-abdominal obesity group, the body mass index, neck circumference, waist circumference, hip circumference, AHI, minimum oxygen saturation and oxygen de-saturation index(ODI)were significantly higher in the abdominal obesity group(all P<0.01). Before correction for any factors, the total score of Mo-CA, visual space and executive score and language score were lower in abdominal obesity group than in non-abdominal obesity group( P<0.01). After adjusting for gender, age, years of education, smoking history, drinking history, AHI and other factors, there were still significant differences in visual space, executive score and language score between the two groups( P<0.05), but there was no significant difference in the total score of Mo-Ca( P>0.05). The correct number of SDMT(40.4±14.5)was lower in non-abdominal obesity group than in abdominal obesity group(44.4±9.0), but the difference was not statistically significant( t=1.887, P>0.05). After adjusting for gender, age, years of education, smoking history, and drinking history, there was still no significant difference in AHI and other factors between the two groups( P>0.05). Regression analysis results showed that independent influencing factors of the total Mo-CA score were age, education, abdominal obesity, and AHI>30( β=-0.174, 0.213, 0.011, 0.158, respectively all P<0.05); the independent influencing factors of visual space and execution ability were the years of education and the abdominal obesity( β=0.182, -0.038, P<0.01); the independent influence factors of naming were gender( β=-0.176, P<0.01); independent influencing factors of attention were age( β=-0.159, P<0.01); independent influencing factors of language were abdominal obesity( β=-0.203, P<0.01); independent influences factors for abstract thinking ability were the length of education( β=0.204, P<0.01); independent influencing factors for delay recall were age, years of education and AHI>30(βvalues were -0.206, -0.125, and -0.174, respectively, all P<0.05, respectively); independent influencing factors for SDMT correct number were age, years of education(β values were -0.177, 0.153, respectively, all P<0.01, respectively). Interaction analysis results showed that there was an interaction between AHI and abdominal obesity in language score( P<0.05). Conclusions:Abdominal obesity can impair the visuospatial and executive abilities as well as language ability in moderate to severe obstructive sleep apnea patients.And there is an interaction between apnea-hypopnea index and MO-CA scores in language ability.