Analysis Of The Value Of Neck Circumference Combined With HbA1c In Screening Obese Patients With OSA

Objective: At present,obesity has become one of the main problems that threaten human health.It has increased by two times worldwide since 1975,but it is known that the United States only defined it as a disease in 2013.The incidence of obesity is gradually increasing,and the subsequent complications have also become the focus of medical attention.Among them,obstructive sleep apnea(OSA),type 2 diabetes(T2DM),cardiovascular disease(CVD),etc.are more common.According to epidemiological investigations,there is a linear relationship between the incidence of OSA and the incidence of obesity.OSA can not only increase obesity and affect blood sugar,but also cause serious complications such as sudden death at night.In view of the high incidence of OSA in obese patients and its possible serious consequences,early identification and diagnosis of OSA in obese people is particularly important.The current gold standard for OSA diagnosis is polysomnography(PSG),but its application is limited due to its high price,complicated operation,and poor patient tolerance.The commonly used screening tools such as Epworth Sleepiness Scale(ESS)and Stop-Bang Questionnaire also reduce the accuracy of diagnosis due to their low sensitivity and specificity.Therefore,finding an accurate and simple screening method has become a current research hotspot.This study combined blood glucose-related indicators and general measurement indicators to explore the risk factors for OSA in obese patients,and to study the value of its screening to find the best early screening indicators.Methods: A collection of 119 obese patients who were expected to undergo weight loss and metabolic surgery in the Second Hospital of Anhui Medical University from November 2018 to May 2020.The height,weight,neck circumference,waist circumference,and abdominal circumference of all subjects were measured by a dedicated person,and BMI was calculated.In the evening,polysomnography(PSG)was performed,and the Epworth Sleepiness Scale(ESS)and Stop-Bang questionnaire were improved before the monitoring.According to PSG results,119 obese patients were divided into non-OSA group(32 cases)and OSA group(87 cases).All subjects were tested for glycosylated hemoglobin(HbA1c),fasting plasmaaglucose(FPG),and 2h blood glucose(2h PG)after oral glucose tolerance test.All data are statistically analyzed by SPSS23.0 software,the measurement data conforming to the normal distribution are expressed as sx ?,and the χ2 test is used for the analysis of count data.Logistic regression analysis is used to obtain meaningful variables,and finally ROC curve is drawn for these variables,and the best cut-off value of the variables is used to predict OSA.Correlation analysis adopts Pearson linear correlation analysis.P<0.05 means the difference is statistically significant.Results: 1.The average levels of neck circumference,waist circumference,BMI,2h PG,FPG,and HbA1 c values in the OSA group were higher than those in the non-OSA group;meanwhile,the OSA group had higher scores on the ESS scale and STOP-Bang scale than the non-OSA group,and the average pulse oxygen Saturation(MSp O2)and Lowest pulse oxygen saturation(LSp O2)were lower than those in the simple obesity group(P<0.05).2.A single factor Logistic regression analysis showed that there was no statistical significance between the non-OSA group and the OSA group except for the age factor(P>0.05),and the other influencing factors were statistically significant(P<0.05).Further multivariate logistic regression analysis showed that the independent influencing factors of OSA mainly included neck circumference and HbA1c(P<0.05).3.Receiver operating characteristic curve(ROC)analysis shows that the area under the curve(AUC)of HbA1 c and neck circumference are 0.813,0.909,respectively.Both were higher than Epworth Sleepiness Scale and STOP-Bang score(AUC: 0.638,0.739,respectively).The combined use of HbA1 c and neck circumference indicators can increase the AUC to 0.934.The sensitivity in the diagnosis of obese patients with OSA is 85.1%,and the specificity is96.9%.Conclusion: Neck circumference and HbA1 c have good diagnostic value for obese patients with OSA.At the same time,joint detection of neck circumference and HbA1 c can effectively improve the sensitivity and specificity of OSA diagnosis,and can better replace the ESS and STOP-Bang scales,and can be used for screening obese patients with OSA.