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Effects of sex, age, and body mass index on serum bicarbonate
RATIONALE: Obesity hypoventilation syndrome (OHS) is often underdiagnosed, with significant morbidity and mortality. Bicarbonate, as a surrogate of arterial carbon dioxide, has been proposed as a screening tool for OHS. Understanding the predictors of serum bicarbonate could provide insights into ri...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10512520/ https://www.ncbi.nlm.nih.gov/pubmed/37736141 http://dx.doi.org/10.3389/frsle.2023.1195823 |
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author | Duan, Daisy Perin, Jamie Osman, Adam Sgambati, Francis Kim, Lenise J. Pham, Luu V. Polotsky, Vsevolod Y. Jun, Jonathan C. |
author_facet | Duan, Daisy Perin, Jamie Osman, Adam Sgambati, Francis Kim, Lenise J. Pham, Luu V. Polotsky, Vsevolod Y. Jun, Jonathan C. |
author_sort | Duan, Daisy |
collection | PubMed |
description | RATIONALE: Obesity hypoventilation syndrome (OHS) is often underdiagnosed, with significant morbidity and mortality. Bicarbonate, as a surrogate of arterial carbon dioxide, has been proposed as a screening tool for OHS. Understanding the predictors of serum bicarbonate could provide insights into risk factors for OHS. We hypothesized that the bicarbonate levels would increase with an increase in body mass index (BMI), since the prevalence of OHS increases with obesity. METHODS: We used the TriNetX Research Network, an electronic health record database with de-identified clinical data from participating healthcare organizations across the United States, to identify 93,320 adults without pulmonary or advanced renal diseases who had serum bicarbonate and BMI measurements within 6 months of each other between 2017 and 2022. We used linear regression analysis to examine the associations between bicarbonate and BMI, age, and their interactions for the entire cohort and stratified by sex. We also applied a non-linear machine learning algorithm (XGBoost) to examine the relative importance of age, BMI, sex, race/ethnicity, and obstructive sleep apnea (OSA) status on bicarbonate. RESULTS: This cohort population was 56% women and 72% white and 80% non-Hispanic individuals, with an average (SD) age of 49.4 (17.9) years and a BMI of 29.1 (6.1) kg/m(2). The mean bicarbonate was 24.8 (2.8) mmol/L, with higher levels in men (mean 25.2 mmol/L) than in women (mean 24.4 mmol/L). We found a small negative association between bicarbonate and BMI, with an expected change of −0.03 mmol/L in bicarbonate for each 1 kg/m(2) increase in BMI (p < 0.001), in the entire cohort and both sexes. We found sex differences in the bicarbonate trajectory with age, with women exhibiting lower bicarbonate values than men until age 50, after which the bicarbonate levels were modestly higher. The non-linear machine learning algorithm similarly revealed that age and sex played larger roles in determining bicarbonate levels than the BMI or OSA status. CONCLUSION: Contrary to our hypothesis, BMI is not associated with elevated bicarbonate levels, and age modifies the impact of sex on bicarbonate. |
format | Online Article Text |
id | pubmed-10512520 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
record_format | MEDLINE/PubMed |
spelling | pubmed-105125202023-09-21 Effects of sex, age, and body mass index on serum bicarbonate Duan, Daisy Perin, Jamie Osman, Adam Sgambati, Francis Kim, Lenise J. Pham, Luu V. Polotsky, Vsevolod Y. Jun, Jonathan C. Front Sleep Article RATIONALE: Obesity hypoventilation syndrome (OHS) is often underdiagnosed, with significant morbidity and mortality. Bicarbonate, as a surrogate of arterial carbon dioxide, has been proposed as a screening tool for OHS. Understanding the predictors of serum bicarbonate could provide insights into risk factors for OHS. We hypothesized that the bicarbonate levels would increase with an increase in body mass index (BMI), since the prevalence of OHS increases with obesity. METHODS: We used the TriNetX Research Network, an electronic health record database with de-identified clinical data from participating healthcare organizations across the United States, to identify 93,320 adults without pulmonary or advanced renal diseases who had serum bicarbonate and BMI measurements within 6 months of each other between 2017 and 2022. We used linear regression analysis to examine the associations between bicarbonate and BMI, age, and their interactions for the entire cohort and stratified by sex. We also applied a non-linear machine learning algorithm (XGBoost) to examine the relative importance of age, BMI, sex, race/ethnicity, and obstructive sleep apnea (OSA) status on bicarbonate. RESULTS: This cohort population was 56% women and 72% white and 80% non-Hispanic individuals, with an average (SD) age of 49.4 (17.9) years and a BMI of 29.1 (6.1) kg/m(2). The mean bicarbonate was 24.8 (2.8) mmol/L, with higher levels in men (mean 25.2 mmol/L) than in women (mean 24.4 mmol/L). We found a small negative association between bicarbonate and BMI, with an expected change of −0.03 mmol/L in bicarbonate for each 1 kg/m(2) increase in BMI (p < 0.001), in the entire cohort and both sexes. We found sex differences in the bicarbonate trajectory with age, with women exhibiting lower bicarbonate values than men until age 50, after which the bicarbonate levels were modestly higher. The non-linear machine learning algorithm similarly revealed that age and sex played larger roles in determining bicarbonate levels than the BMI or OSA status. CONCLUSION: Contrary to our hypothesis, BMI is not associated with elevated bicarbonate levels, and age modifies the impact of sex on bicarbonate. 2023 2023-07-20 /pmc/articles/PMC10512520/ /pubmed/37736141 http://dx.doi.org/10.3389/frsle.2023.1195823 Text en https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Article Duan, Daisy Perin, Jamie Osman, Adam Sgambati, Francis Kim, Lenise J. Pham, Luu V. Polotsky, Vsevolod Y. Jun, Jonathan C. Effects of sex, age, and body mass index on serum bicarbonate |
title | Effects of sex, age, and body mass index on serum bicarbonate |
title_full | Effects of sex, age, and body mass index on serum bicarbonate |
title_fullStr | Effects of sex, age, and body mass index on serum bicarbonate |
title_full_unstemmed | Effects of sex, age, and body mass index on serum bicarbonate |
title_short | Effects of sex, age, and body mass index on serum bicarbonate |
title_sort | effects of sex, age, and body mass index on serum bicarbonate |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10512520/ https://www.ncbi.nlm.nih.gov/pubmed/37736141 http://dx.doi.org/10.3389/frsle.2023.1195823 |
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