Model for Identifying High Carotid Body Chemosensitivity in Patients with Obstructive Sleep Apnea

Hong Peng Li,1,2,* Hai Qin Wang,3,* Ning Li,1,2,* Liu Zhang,1,2 Shi Qi Li,1,2 Ya Ru Yan,1,2 Huan Huan Lu,1,2 Yi Wang,1,2 Xian Wen Sun,1,2 Ying Ni Lin,1,2 Jian Ping Zhou,1,2 Qing Yun Li1,2 1Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of...

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Main Authors:	Li HP, Wang HQ, Li N, Zhang L, Li SQ, Yan YR, Lu HH, Wang Y, Sun XW, Lin YN, Zhou JP, Li QY
Format:	article
Language:	EN
Published:	Dove Medical Press 2021
Subjects:	carotid body chemosensitivity obstructive sleep apnea severity indicator Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Online Access:	https://doaj.org/article/46a890cbcfe94d27a32a056373455ae3
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spelling	oai:doaj.org-article:46a890cbcfe94d27a32a056373455ae32021-12-02T18:31:08ZModel for Identifying High Carotid Body Chemosensitivity in Patients with Obstructive Sleep Apnea1179-1608https://doaj.org/article/46a890cbcfe94d27a32a056373455ae32021-04-01T00:00:00Zhttps://www.dovepress.com/model-for-identifying-high-carotid-body-chemosensitivity-in-patients-w-peer-reviewed-fulltext-article-NSShttps://doaj.org/toc/1179-1608Hong Peng Li,1,2,* Hai Qin Wang,3,* Ning Li,1,2,* Liu Zhang,1,2 Shi Qi Li,1,2 Ya Ru Yan,1,2 Huan Huan Lu,1,2 Yi Wang,1,2 Xian Wen Sun,1,2 Ying Ni Lin,1,2 Jian Ping Zhou,1,2 Qing Yun Li1,2 1Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China; 2Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China; 3Xietu Community Health Service Center of Xuhui District, Shanghai, 200231, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qing Yun LiDepartment of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Rui Jin 2nd Road, Shanghai 200025, PR China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, No. 197 Rui Jin 2nd Road, Shanghai, 200025, People’s Republic of ChinaTel +86-21-64370045Fax +86-21-62836805Email liqingyun68@hotmail.comObjective: The carotid body (CB) is a major peripheral respiratory chemoreceptor. In patients with obstructive sleep apnea (OSA), high CB chemosensitivity (CBC) is associated with refractory hypertension and insulin resistance and known to further aggravate OSA. Thus, the identification of high CB (hCBC) among OSA patients is of clinical significance, but detection methods are still limited. Therefore, this study aimed to explore the association of CBC with OSA severity and to develop a simplified model that can identify patients with hCBC.Methods: In this cross-sectional study of subjects who underwent polysomnography (PSG), CBC was measured using the Dejours test. We defined hCBC as a decrease of > 12% in respiratory rate (RR) after breathing of pure O2. The association of CBC with OSA severity was explored by logistic regression, and a model for identifying hCBC was constructed and confirmed using receiver operating characteristic analysis.Results: Patients with OSA (n=142) and individuals without OSA (n=38) were enrolled. CBC was higher in patients with OSA than in those without OSA (% decrease in RR, 15.2%± 13.3% vs 9.1%± 7.5%, P< 0.05). Apnea-hypopnea index (AHI), fraction of apnea-hypopnea events in rapid-eye-movement sleep (Fevents-in-REM), and longest time of apnea (LTA) were associated with hCBC independently (odds ratio [OR]=1.048, OR=1.082, and OR=1.024 respectively; all P< 0.05). The model for identifying hCBC allocated a score to each criterion according to its OR values, ie, 1 (LTA > 48.4 s), 2 (AHI > 15.7 events/hour), and 3 (Fevents-in-REM > 12.7%). A score of 3 or greater indicated hCBC with a sensitivity of 79.4% and specificity of 88.2%.Conclusion: High CBC is associated with the severity of OSA. A simplified scoring system based on clinical variables from PSG can be used to identify hCBC.Keywords: carotid body, chemosensitivity, obstructive sleep apnea, severity, indicatorLi HPWang HQLi NZhang LLi SQYan YRLu HHWang YSun XWLin YNZhou JPLi QYDove Medical Pressarticlecarotid bodychemosensitivityobstructive sleep apneaseverityindicatorPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 13, Pp 493-501 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	carotid body chemosensitivity obstructive sleep apnea severity indicator Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	carotid body chemosensitivity obstructive sleep apnea severity indicator Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Li HP Wang HQ Li N Zhang L Li SQ Yan YR Lu HH Wang Y Sun XW Lin YN Zhou JP Li QY Model for Identifying High Carotid Body Chemosensitivity in Patients with Obstructive Sleep Apnea
description	Hong Peng Li,1,2,* Hai Qin Wang,3,* Ning Li,1,2,* Liu Zhang,1,2 Shi Qi Li,1,2 Ya Ru Yan,1,2 Huan Huan Lu,1,2 Yi Wang,1,2 Xian Wen Sun,1,2 Ying Ni Lin,1,2 Jian Ping Zhou,1,2 Qing Yun Li1,2 1Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China; 2Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People’s Republic of China; 3Xietu Community Health Service Center of Xuhui District, Shanghai, 200231, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qing Yun LiDepartment of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Rui Jin 2nd Road, Shanghai 200025, PR China; Institute of Respiratory Medicine, Shanghai Jiao Tong University School of Medicine, No. 197 Rui Jin 2nd Road, Shanghai, 200025, People’s Republic of ChinaTel +86-21-64370045Fax +86-21-62836805Email liqingyun68@hotmail.comObjective: The carotid body (CB) is a major peripheral respiratory chemoreceptor. In patients with obstructive sleep apnea (OSA), high CB chemosensitivity (CBC) is associated with refractory hypertension and insulin resistance and known to further aggravate OSA. Thus, the identification of high CB (hCBC) among OSA patients is of clinical significance, but detection methods are still limited. Therefore, this study aimed to explore the association of CBC with OSA severity and to develop a simplified model that can identify patients with hCBC.Methods: In this cross-sectional study of subjects who underwent polysomnography (PSG), CBC was measured using the Dejours test. We defined hCBC as a decrease of > 12% in respiratory rate (RR) after breathing of pure O2. The association of CBC with OSA severity was explored by logistic regression, and a model for identifying hCBC was constructed and confirmed using receiver operating characteristic analysis.Results: Patients with OSA (n=142) and individuals without OSA (n=38) were enrolled. CBC was higher in patients with OSA than in those without OSA (% decrease in RR, 15.2%± 13.3% vs 9.1%± 7.5%, P< 0.05). Apnea-hypopnea index (AHI), fraction of apnea-hypopnea events in rapid-eye-movement sleep (Fevents-in-REM), and longest time of apnea (LTA) were associated with hCBC independently (odds ratio [OR]=1.048, OR=1.082, and OR=1.024 respectively; all P< 0.05). The model for identifying hCBC allocated a score to each criterion according to its OR values, ie, 1 (LTA > 48.4 s), 2 (AHI > 15.7 events/hour), and 3 (Fevents-in-REM > 12.7%). A score of 3 or greater indicated hCBC with a sensitivity of 79.4% and specificity of 88.2%.Conclusion: High CBC is associated with the severity of OSA. A simplified scoring system based on clinical variables from PSG can be used to identify hCBC.Keywords: carotid body, chemosensitivity, obstructive sleep apnea, severity, indicator
format	article
author	Li HP Wang HQ Li N Zhang L Li SQ Yan YR Lu HH Wang Y Sun XW Lin YN Zhou JP Li QY
author_facet	Li HP Wang HQ Li N Zhang L Li SQ Yan YR Lu HH Wang Y Sun XW Lin YN Zhou JP Li QY
author_sort	Li HP
title	Model for Identifying High Carotid Body Chemosensitivity in Patients with Obstructive Sleep Apnea
title_short	Model for Identifying High Carotid Body Chemosensitivity in Patients with Obstructive Sleep Apnea
title_full	Model for Identifying High Carotid Body Chemosensitivity in Patients with Obstructive Sleep Apnea
title_fullStr	Model for Identifying High Carotid Body Chemosensitivity in Patients with Obstructive Sleep Apnea
title_full_unstemmed	Model for Identifying High Carotid Body Chemosensitivity in Patients with Obstructive Sleep Apnea
title_sort	model for identifying high carotid body chemosensitivity in patients with obstructive sleep apnea
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/46a890cbcfe94d27a32a056373455ae3
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Model for Identifying High Carotid Body Chemosensitivity in Patients with Obstructive Sleep Apnea

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