The Value Of Ascending Aortic Diameter Measurement Combined With NoSAS Questionnaire In Screening OSA In Physical Examination Population

Objective With the increase of global obesity,the prevalence of OSA is increasing,and the trend of younger age is becoming more and more serious.As the most common sleep-disordered breathing disease,there are many types of symptoms associated with OSA,which can lead to depression,metabolism,neurocognition,cardiovascular and other complications,especially cardiovascular system damage,which can lead to aortic dilatation.Many patients lack of understanding and attention to the disease of OSA until serious complications occur.Therefore,a rapid and simple screening method is needed to enable more patients to detect and manage this chronic disease earlier.The current gold standard test for OSA is PSG,but its expensive and time-consuming examination process limits its wide application.Now,the most widely used in clinical practice is different OSA-assisted screening questionnaires,and the NoSAS questionnaire is a simple and effective questionnaire.It is a new screening tool based on Berlin questionnaire,STOP-Bang questionnaire,Epworth sleepiness scale and other questionnaires.In recent years,low-dose chest CT has been widely used in health examination.It can not only locate and preliminarily diagnose lung lesions,but also display the diameter of thoracic large vessels.This study analyzed the application value of measuring the diameter of ascending aorta on low-dose chest CT combined with NoSAS questionnaire in screening OSA in physical examination population.Methods From December 2021 to July 2022,453 patients with sleep snoring who underwent polysomnography(PSG)monitoring in the Health Management Center of Chaohu Hospital Affiliated to Anhui Medical University were selected as subjects.Inclusion criteria : 1 Age 18-60 years old,the main symptom is sleep snoring,which affects sleep quality;2 Complete clinical data,including low-dose chest CT and polysomnography results.Among them,65.3 %(296 cases)were male and 34.7 %(157 cases)were female.A total of 107 patients(AHI30)were enrolled in the non-OSA group.All patients underwent low-dose chest CT scan and filled out the NoSAS questionnaire to measure the ascending aortic diameter(AAD).The receiver operating characteristic(ROC)curve was drawn to compare the screening value of NoSAS questionnaire combined with AAD measurement and single NoSAS questionnaire for OSA.Results Logistic regression model was established with ascending aorta diameter measured by NoSAS questionnaire combined with low-dose chest CT as independent variables.OSA diagnostic criteria were AHI ≥ 5 times / h,15 times / h and 30 times / h.The sensitivity and specificity of NoSAS questionnaire were 0.882 and 0.664,0.906 and0.592,0.806 and 0.511,respectively.The sensitivity and specificity of NoSAS questionnaire combined with AAD were 0.896 and 0.682,0.926 and 0.652,0.857 and0.678,respectively.Conclusion The NoSAS questionnaire is a more objective and repeatable questionnaire response rate.It is a more objective and repeatable questionnaire,and shows better discrimination than other screening tools.Studies have confirmed that there is a high degree of similarity between contrast-free and contrast-enhanced computed tomography in assessing the size of large blood vessels.Low-dose chest CT scan is one of the routine physical examination items.It is easy to measure the ascending aortic diameter(AAD)of chest CT.The above two methods have certain application value in the screening and evaluation of OSA.When AHI ≥ 5,15,30 times / h was used as the diagnostic criteria for OSA,the AUC,sensitivity and specificity of NoSAS questionnaire combined with AAD were significantly higher than those of single NoSAS questionnaire,which confirmed that NoSAS questionnaire combined with AAD measurement had good application and promotion value.