Change Of Microalbuminuria In Patients With Obstructive Sleep Apnea-chronic Obstructive Pulmonary Disease Overlap Syndrome And Its Influencing Factors

Objective:In this study,we investigated the change of microalbuminuria?MA?in patients with obstructive sleep apnea?OSAS?-chronic obstructive pulmonary desease?COPD?overlap syndrome?OS?and its influencing factors.Methods:One hundred and forty-four subjects who underwent polysomnography were enrolled in this study,which included 48 subjects definitely diagnosed as chronic obstructive pulmonary disease?COPD?,36 diagnosed as obstructive sleep apnea hypopnea syndrome?OSAS?patients and 28 overlap syndrome patients with coexistence of two diseases.Thirty-two controls without COPD and OSAS were also included.Microalbuminuria was defined as a random urinary albumin/creatinine ratio?UACR?of 20 to 300 mg/g.In this research,we mersured the UACR levels of the subjects and evaluated the correlation between clinical indexes such as body mass index?BMI?,lowest oxygen saturation?LSpO₂?,FEV₁/FVC%,FEV₁%,PaO₂,PaCO₂,apnea hypopnea index?AHI?and miroalbuminuria.The relationgs between UACR and clinical indexes were examined by using pearson correlation.Multivariate linear regression examined the influencing factors of microalbuminuria in overlap syndrome.Results:UACR levels were signicantly higher in OS,COPD and OSAS group compared with control group?P<0.05?.Prevalence of microalbuminuria increased signifycantly in the order of control,OSA,COPD and overlap syndrome groups?3.1,11.1,12.5 and35.7%,respectively;P<0.05?.After bonferroni correction,there was statistical difference between the OS group and the control group?P<0.05?.Pearson correlation analysis showed that UACR was positively correlated with BMI and AHI?r=0.540,P<0.05;r=0.743,P<0.05?,while LSpO₂,FEV₁/FVC%,and PaO₂ showed a significant negative correlation with UACR?r=-0.660,P<0.05;r=-0.648,P<0.05;r=-0.811,P<0.05?.In multivariate linear regression analysis,there was a significant positive correlation between AHI and UACR??=0.737,P<0.05?,while there was a significant negative correlation between PaO₂ and UACR??=-0.631,P<0.05?.Conclusion:The prevalence of microalbuminuria in patients with OSAS-COPD overlap syndrome is generally increased,hypoxemia and the severity of AHI may be its influencing factors.