Data_Sheet_1_The relationship between obstructive sleep apnea and osteoarthritis: evidence from an observational and Mendelian randomization study.docx

ObjectivesObstructive sleep apnea (OSA) and osteoarthritis (OA) are common comorbidities that significantly impact individuals’ quality of life. However, the relationship between OSA and OA remains unclear. This study aims to explore the connection between OSA and OA and evaluate causality using Mendelian randomization (MR).
MethodsA total of 12,454 participants from the National Health and Nutrition Examination Survey (2009–2012) were included. OSA participants were identified based on self-reported interviews. The association between OA and OSA was assessed through multivariable logistic regression analysis. A two-sample MR was employed to investigate the relationship between OSA and OA, specifically hip OA and knee OA, utilizing the inverse variance-weighted (IVW) approach.
ResultsBased on the observational study, individuals with OSA exhibited a higher risk of OA (OR = 1.67, 95% CI = 1.40–1.98). IVW demonstrated that the risk of OA (OR = 1.13, 95% CI: 1.05–1.21, p = 0.001), hip OA (OR = 1.11, 95% CI: 1.04–1.18, p = 0.002), and knee OA (OR = 1.08, 95% CI: 1.02–1.14, p = 0.005) was significantly associated with OSA. Reverse MR analyses indicated no effect of OA on OSA. Additionally, body mass index (BMI) was found to mediate 36.9% (95% CI, 4.64–73.2%, p = 0.026) of the OSA effects on OA risk.
ConclusionThe cross-sectional observational analysis unveiled noteworthy associations between OSA and OA. Meanwhile, findings from the MR study provide support for a causal role.

研究目标
阻塞性睡眠呼吸暂停（Obstructive sleep apnea, OSA）与骨关节炎（osteoarthritis, OA）是常见共病，二者均会显著影响个体的生活质量，但目前二者间的关联仍不明确。本研究旨在探究OSA与OA之间的关联，并利用孟德尔随机化（Mendelian randomization, MR）方法评估二者的因果关系。

研究方法
本研究纳入了美国国家健康与营养调查（National Health and Nutrition Examination Survey, 2009–2012）中的12454名参与者。OSA患者通过自我报告访谈进行识别。采用多变量logistic回归分析评估OA与OSA的关联；同时采用两样本孟德尔随机化（two-sample MR）结合逆方差加权（inverse variance-weighted, IVW）法，探究OSA与OA（包括髋部OA及膝部OA）之间的关联。

研究结果
基于观察性研究结果，OSA患者的OA发病风险显著升高（比值比OR=1.67，95%置信区间CI=1.40–1.98）。逆方差加权分析显示，OSA与总体OA（OR=1.13，95%CI: 1.05–1.21, p=0.001）、髋部OA（OR=1.11，95%CI: 1.04–1.18, p=0.002）及膝部OA（OR=1.08，95%CI: 1.02–1.14, p=0.005）的发病风险均存在显著关联。反向孟德尔随机化分析表明，OA对OSA并无显著影响。此外，体质量指数（body mass index, BMI）介导了OSA对OA发病风险36.9%的效应（95%CI, 4.64–73.2%, p=0.026）。

研究结论
横断面观察性分析揭示了OSA与OA之间存在值得关注的关联；同时，孟德尔随机化研究结果为OSA在OA发病中的因果作用提供了支持。