Study On The Relationship Between Obesity And Cognitive Impairment In Patients With Obstructive Sleep Apnea Hypopnea Syndrome

Objective: The Chinese version of Montreal Cognitive Assessment scale(Montrealcognitiveassessment,MoCA)was used to evaluate the changes of cognitive function in patients with obesity and obstructive sleep apnea hypopnea syndrome(OSAHS),and the degree of daytime sleepiness was assessed by Epworth sleepiness scale(Epworth Sleepinesss Scale,ESS)to explore the related factors of cognitive function in patients with obesity and different degrees of OSAHS.Methods: Children with obstructive sleep apnea hypopnea syndrome(OSAHS)were diagnosed by polysomnography(PSG).The OSAHS in accordance with this study was divided into mild,moderate and severe according to PSG,and divided into four groups according to body mass index(BMI,unit kg/m2): normal weight,mild overweight,severe overweight and obesity group.Montreal Cognitive function rating scale(MoCA)and Epworth sleepiness scale(Epworth Sleepinesss Scale,ESS)were used to evaluate and analyze the related factors.Results: 1.There was no significant difference in age,sex,years of education and sex between patients with different degrees of OSAHS and patients with different weight of OSAHS,but there were significant differences in ESS,BMI,neck circumference and PSG between severe group and other groups,obese group and normal body weight group.2.The total score of MoCA,visual space / executive ability,delayed memory,abstraction,attention and orientation were impaired in severe patients,while the total score of MoCA,visual spatial / executive ability,delayed memory and abstraction were impaired in obese group.3.Correlation analysis of MoCA scale in OSAHS patients with different degrees showed that the total score of MoCA was negatively correlated with age,ESS,AHI,RI,ODI and TS90%.It was positively correlated with years of education,LSa O2 and deep sleep(r = 0.231).The total score of MoCA was negatively correlated with age,BMI,AHI,RI,ODI and light sleep III/TST% in OSAHS patients with different body weight(r = 0.269,r = 0.211,r = 0.359,P < 0.01),and positively correlated with years of education(r = 0.291,r = 0.212,r = 0.299,r = 0.211,r = 0.211,r = 0.359,r = 0.081,r = 0.211,r = 0.211,r = 0.212,r = 0.212,P < 0.01).4.Multivariate Logistic regression analysis showed that the independent influencing factors of MoCA score in patients with different degrees of OSAHS were years of education,AHI and LSa O2;.In patients with different body weight of OSAHS,age,years of education,AHI and BMI were independent factors of MoCA score.Two-factor analysis of variance BMI and AHI had significant influence on MoCA score,but the effect of BMI did not change with the change of AHI.Conclusion: 1.Both obesity and OSAHS can lead to cognitive impairment in patients with OSAHS,and obesity can aggravate cognitive impairment in patients with OSAHS,but obesity is one of the important factors affecting cognitive function independent of AHI.2.The higher the value of MBI and AHI,the more obvious the impairment of cognitive function,MBI and AHI are positively correlated with the degree of hypoxia,repeated intermittent hypoxia may be one of the main causes of cognitive impairment in patients with obesity and OSAHS.3.Age,years of education,BMI and AHI are common independent predictors of obesity and OSAHS to MoCA score.4.Cognitive impairment in patients with OSAHS is mainly manifested in visual space / executive function,delayed memory,attention,language and abstractness,and visual space / executive ability and delayed memory are common risk factors for obesity and different degrees of OSAHS.