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Sweatt K, Garvey WT, Martins C. Strengths and Limitations of BMI in the Diagnosis of Obesity: What is the Path Forward? Curr Obes Rep 2024; 13:584-595. [PMID: 38958869 PMCID: PMC11306271 DOI: 10.1007/s13679-024-00580-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE OF REVIEW This review aims to discuss strengths and limitations of body mass index (BMI) in diagnosing obesity, the use of alternative anthropometric measurements, and potential new technology that may change the future of obesity diagnosis and management. RECENT FINDINGS The diagnosis of obesity requires the anthropometric assessment of adiposity. In clinical settings, this should include BMI with confirmation that elevated BMI represents excess adiposity and a measure of fat distribution (i.e., waist circumference (WC), waist to height ratio (WHtR), or WC divided by height0.5 (WHR.5R). Digital anthropometry and bioelectric impedance (BIA) can estimate fat distribution and be feasibly employed in the clinic. In addition, the diagnosis should include a clinical component assessing the presence and severity of weight-related complications. As anthropometric measures used in the diagnosis of obesity, BMI is generally sufficient if confirmed to represent excess adiposity, and there are advantages to the use of WHtR over WC to assess fat distribution. BIA and digital anthropometry have the potential to provide accurate measures of fat mass and distribution in clinical settings. There should also be a clinical evaluation for the presence and severity of obesity complications that can be used to stage the disease.
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Affiliation(s)
- Katherine Sweatt
- Department of Nutrition Sciences, University of Alabama at Birmingham, 675 University Blvd, Birmingham, AL, 35294-3360, USA
| | - W Timothy Garvey
- Department of Nutrition Sciences, University of Alabama at Birmingham, 675 University Blvd, Birmingham, AL, 35294-3360, USA
| | - Catia Martins
- Department of Nutrition Sciences, University of Alabama at Birmingham, 675 University Blvd, Birmingham, AL, 35294-3360, USA.
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Wang C, Shi M, Lin C, Wang J, Xie L, Li Y. Association between the triglyceride glucose index and obstructive sleep apnea and its symptoms: results from the NHANES. Lipids Health Dis 2024; 23:133. [PMID: 38705980 PMCID: PMC11071203 DOI: 10.1186/s12944-024-02125-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/29/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Certain studies have indicated a link between obstructive sleep apnea and insulin resistance in specific populations. To gain more clarity, extensive research involving a broad sample of the overall population is essential. The primary objective of this study was to investigate this correlation by utilizing data from the National Health and Nutrition Examination Survey database. METHODS The analysis incorporated data from the National Health and Nutrition Examination Survey database spanning the time periods from 2005 to 2008 and from 2015 to 2018, with a focus on American adults aged 18 years and older after applying weight adjustments. Key variables such as obstructive sleep apnea, triglyceride glucose index, and various confounding factors were considered. A generalized linear logistic regression model was used to investigate the association between obstructive sleep apnea and the triglyceride glucose index, with additional exploration of the consistency of the results through hierarchical analysis and other techniques. RESULTS The study included participants aged between 18 and 90 years, with an average age of 46.75 years. Among the total sample, 50.76% were male. The triglyceride glucose index demonstrated a diagnostic capability for obstructive sleep apnea, with an AUC of 0.701 (95% CI: 0.6619-0.688). According to the fully adjusted model, individuals in the fourth quartile of the triglyceride glucose index showed an increased likelihood of having obstructive sleep apnea compared to those in the first quartile (OR: 1.45; 95% CI: 1.02-2.06; P < 0.05). Subgroup analysis indicated that male sex (OR: 2.09; 95% CI: 1.76-2.45; P < 0.05), younger age (OR: 2.83; 95% CI: 2.02-3.96; P < 0.05), white ethnicity (OR: 2.29; 95% CI: 1.93-2.73; P < 0.05), and obesity (OR: 1.54; 95% CI: 1.28-1.85; P < 0.05) were correlated with an elevated risk of OSA. CONCLUSIONS This study demonstrated a strong association between an elevated TG index and OSA. Additionally, the triglyceride glucose index could serve as an independent predictor of obstructive sleep apnea.
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Affiliation(s)
- Chao Wang
- Heilongjiang University of Traditional Chinese Medicine, Harbin, 150006, China
| | - Mengdi Shi
- Heilongjiang University of Traditional Chinese Medicine, Harbin, 150006, China
| | - Chunsheng Lin
- The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, 150001, China
| | - Jingyi Wang
- The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, 150040, China
| | - Liangzhen Xie
- The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, 150040, China.
| | - Yan Li
- The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, 150040, China.
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Ntimana CB, Seakamela KP, Mashaba RG, Maimela E. Determinants of central obesity in children and adolescents and associated complications in South Africa: a systematic review. Front Public Health 2024; 12:1324855. [PMID: 38716247 PMCID: PMC11075369 DOI: 10.3389/fpubh.2024.1324855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/19/2024] [Indexed: 05/23/2024] Open
Abstract
Background Central obesity in children is a global health concern associated with cardiovascular risk factors. In 2019 the World Obesity Federation predicted that in 2025, 206 million children and adolescents aged 5 to 19 will be obese, and the number is estimated to reach 254 million by 2030. There is limited literature on the factors that are associated with the development of central obesity in children. We report a systematic review, aimed to describe the current literature on determinants of central obesity and its associated health outcomes in children and adolescents in the South African population. Methods We searched for peer-reviewed studies in Google Scholar, PubMed, and Science Direct search engines, and about seven studies were included. This systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) (Registration number: CRD42023457012). This systematic review was conducted and reported according to an updated version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The quality of the included studies was assessed by following guidelines from the Newcastle-Ottawa Scale (NOS). The method considered three main domains: selection, comparability, and outcome across different study designs. Results The prevalence of central obesity in children and adolescents by waist-to-height ratio (WHtR) ranged from 2.0 to 41.0%; waist-to-hip [WHR ranged from 10 to 25%; waist circumference (WC) ranged from 9 to 35%]. Central obesity was associated with age, physical inactivity, gender socio, and demographic profiles of the household. Central obesity in children was associated with cardiovascular diseases and mental health issues. Conclusion Central obesity in children and adolescents was determined by gender, pubertal development, and age of the parents, households with high socioeconomic status, dietary practices, and overweight/obesity. Given the high prevalence of central obesity in children which can ultimately result in cardiometabolic diseases, cardiovascular risk factors, and mental health issues. This highlights the need for systems, jointly initiated by healthcare providers, policymakers, and the general society aimed at reducing the burden of central obesity such as introducing children and adolescents to health-promoting lifestyles.
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Affiliation(s)
- Cairo Bruce Ntimana
- DIMAMO Population Health Research Centre, University of Limpopo, Sovenga, South Africa
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Wang D, Chen Y, Ding Y, Tang Y, Su X, Li S, Zhang H, Zhou Y, Zhuang Z, Gan Q, Wang J, Zhang Y, Zhao D, Zhang N. Application Value of Cardiometabolic Index for the Screening of Obstructive Sleep Apnea with or Without Metabolic Syndrome. Nat Sci Sleep 2024; 16:177-191. [PMID: 38404482 PMCID: PMC10887934 DOI: 10.2147/nss.s449862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/12/2024] [Indexed: 02/27/2024] Open
Abstract
Background Obstructive sleep apnea (OSA) is a common chronic disease with various comorbidities. The cardiometabolic index (CMI) reflects visceral fat tissue distribution and function, assessing the risk of obesity-related conditions such as metabolic syndrome (MetS) and stroke, which are strongly connected to OSA. The relationship between CMI with OSA and OSA combined with MetS (OMS) remains unclear. This study aims to evaluate the screening value of CMI for OSA and OMS, compared to the lipid accumulation product (LAP). Methods A total of 280 participants who underwent polysomnography were finally included, with the measurements of metabolic-related laboratory test results such as total cholesterol and triglyceride. Receiver operating curve (ROC) analysis and calculation of the area under the curve (AUC) were conducted to assess the screening potential of CMI, LAP, and the logistic regression models established based on them for OSA and OMS. The Youden index, sensitivity, and specificity were used to determine the optimal cutoff points. Results ROC curve analysis revealed that the AUCs for CMI in screening OSA and OMS were 0.808 and 0.797, and the optimal cutoff values were 0.71 (sensitivity 0.797, specificity 0.776) and 0.89 (sensitivity 0.830, specificity 0.662), respectively, showing higher Youden index than LAP. The AUCs of screening models based on CMI for OSA and OMS were 0.887 and 0.824, respectively. Conclusion CMI and LAP can effectively screen for OSA and OMS, while CMI has more practical cutoff values for identifying the diseased states. Screening models based on CMI demonstrate a high discriminatory ability for OSA and OMS, which needs verification in a large-scale population.
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Affiliation(s)
- Donghao Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Yating Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Yutong Ding
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Yongkang Tang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Xiaofen Su
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Shiwei Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Haojie Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
- The Clinical Medicine Department, Henan University, Zhengzhou, People’s Republic of China
| | - Yanyan Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Zhiyang Zhuang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Qiming Gan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Jingcun Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Yuting Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Dongxing Zhao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
| | - Nuofu Zhang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510160, People’s Republic of China
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Ren Y, Cui X, Zhu X, Guo H, Zhou Q, Yuan P, Cheng H, Wu W. Effect of Weight Loss on the Apnea Hypopnea Index is Related to Waist Circumference in Chinese Adults with Overweight and Obesity. Diabetes Metab Syndr Obes 2024; 17:453-463. [PMID: 38299196 PMCID: PMC10829506 DOI: 10.2147/dmso.s442738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/09/2024] [Indexed: 02/02/2024] Open
Abstract
Purpose The present study aimed to evaluate the efficiency of traditional anthropometric and body composition parameters in predicting apnea hypopnea index (AHI) change after weight loss. Patients and Methods Chinese adults with overweight and obesity were included into this study containing two parts. A cross-sectional study was conducted in 137 individuals using the baseline data from two weight loss intervention trials. The second part was the weight-loss intervention study conducted in 60 overweight and obese patients with obstructive sleep apnea (OSA). All participants underwent physical examination, bioelectrical impedance analysis and overnight polysomnography. Multivariate linear regression models were used to identify the most accurate parameters to predict AHI and the mediation analysis to evaluate the mediators between weight loss and AHI reduction. Results Waist circumference (WC), body mass index and fat mass were positively associated with AHI after adjusting multiple collinearities in the cross-sectional study. After weight-loss intervention, body weight decreased from 94.6 ± 15.3 to 88.0 ± 13.9 kg, and AHI decreased from 41.9 (13.0,66.9) to 20.7 (8.7,51.2) events/h. Among these parameters, only percentage changes in WC and AHI across the intervention were positively intercorrelated after controlling for covariates (adjusted r = 0.271, P = 0.041). The mediation analysis supported WC as a mediator between weight loss and AHI reduction (standardized indirect effect [95% CI] = 4.272[0.936,7.999]). Conclusion Both general and abdominal obesity are of high prognostic value for OSA. WC as an easily accessible parameter mediates the effects of weight loss in decreasing OSA severity.
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Affiliation(s)
- Ye Ren
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Xiaochuan Cui
- Department of Sleep Center, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Xiaowen Zhu
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Hua Guo
- Department of Sleep Center, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Qunyan Zhou
- Department of Nutrition Department, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Peng Yuan
- Department of Rehabilitation, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Haiyan Cheng
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Wenjun Wu
- Department of Endocrinology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, People’s Republic of China
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Song Y, Gong L, Lou X, Zhou H, Hao Y, Chen Q, Zhao Y, Jiang X, Li L, Wang X. Sleep-Body Composition Relationship: Roles of Sleep Behaviors in General and Abdominal Obesity in Chinese Adolescents Aged 17-22 Years. Nutrients 2023; 15:4130. [PMID: 37836414 PMCID: PMC10574676 DOI: 10.3390/nu15194130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/17/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
This study aimed to investigate the association between sleep behaviors and body composition, which was measured by bioelectrical impedance analysis (BIA) among Chinese adolescents. Overall, 444 students (65.3% females, 19.12 ± 1.177 years) completed questionnaires describing sleep characteristics. Sleep characteristics were derived from subjective means. Body composition was obtained from BIA by InBody 720 (Biospace Co. Ltd., Seoul, Republic of Korea). Regression models tested relationships between sleep and body composition after adjustment for covariates. Students with weekday nap duration (>30 min/d) exerted higher waist-height ratio (WHtR) (B = 0.013, FDR-corrected p = 0.080). Average sleep duration (≤7 h/d) was linked to more WHtR (B = 0.016, FDR-corrected p = 0.080). People with high social jetlag showed gained visceral fat area (B = 7.475), WHtR (B = 0.015), waist to hip ratio (B = 0.012), fat mass index (B = 0.663) and body fat percentage (B = 1.703) (all FDR-corrected p < 0.1). Individuals with screen time before sleep (>0.5 h) exhibited higher visceral fat area (B = 7.934, FDR-corrected p = 0.064), WHtR (B = 0.017, FDR-corrected p = 0.080), waist to hip ratio (B = 0.016, FDR-corrected p = 0.090), fat mass index (B = 0.902, FDR-corrected p = 0.069) and body fat percentage (B = 2.892, FDR-corrected p = 0.018). We found poor sleep characteristics were closely related to general and abdominal obesity.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Xian Wang
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou 450001, China; (Y.S.); (L.G.); (X.L.); (H.Z.); (Y.H.); (Q.C.); (Y.Z.); (X.J.); (L.L.)
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Deng H, Duan X, Huang J, Zheng M, Lao M, Weng F, Su QY, Zheng ZF, Mei Y, Huang L, Yang WH, Xing X, Ma X, Zhao W, Liu X. Association of adiposity with risk of obstructive sleep apnea: a population-based study. BMC Public Health 2023; 23:1835. [PMID: 37735660 PMCID: PMC10512644 DOI: 10.1186/s12889-023-16695-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Obesity is a crucial risk factor for obstructive sleep apnea (OSA), but the association between adiposity deposition and OSA risk has not reached a consistent conclusion. This study sought to reveal the association of multiple adiposity indicators with OSA risk. METHODS This cross-sectional study included 9,733 participants aged 35-74 years, recruited from an ongoing population-based cohort. OSA was assessed by the Berlin Questionnaire. Six adiposity indicators, including neck circumference (NC), body fat percentage (BF%), waist-to-hip ratio (WHR), visceral adiposity index (VAI), lipid accumulation product (LAP), and resting metabolic rate (RMR), were selected. Multivariate logistic regression models were used to examine the association of adiposity indicators with OSA risk. RESULTS One thousand six hundred twenty-six participants (16.71%) were classified into the OSA group. NC, BF%, WHR, VAI, LAP, and RMR were all positively associated with the risk of OSA after adjusting for confounders, regardless of age, sex, and history of dyslipidemia. Every 1-unit increment of NC, BF%, and VAI was associated with a 13%, 9%, and 14% increased risk of OSA, respectively; every 0.01-unit increment of WHR was associated with a 3% increased risk of OSA; every 10-unit increment of LAP and RMR was associated with 2% and 4% increased risk of OSA, respectively. CONCLUSIONS NC, BF%, WHR, VAI, LAP, and RMR were all independently and positively associated with OSA risk, regardless of age, sex, history of dyslipidemia, and menopausal status. Application of these new indicators could help to more comprehensively reflect and predict the risk of OSA in the general population.
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Affiliation(s)
- Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Southern Medical University, Guangzhou, 510080, China
| | - Xueru Duan
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Jun Huang
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Southern Medical University, Guangzhou, 510080, China
| | - Murui Zheng
- Faculty of Health Sciences, University of Macau, Macau SAR, 999078, China
| | - Miaochan Lao
- Department of Sleep Center, Department of Geriatric Respiratory, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Fan Weng
- Guangzhou Yuexiu District Center for Disease Control and Prevention, Guangzhou, 510080, China
| | - Qi-Ying Su
- Dadong Street Community Health Service Center, Guangzhou, 510080, China
| | - Zhen-Feng Zheng
- Nancun Community Health Service Center, Guangzhou, 511442, China
| | - Yunting Mei
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Li Huang
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Wen-Han Yang
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China
| | - Xiaohui Xing
- Guangdong Provincial Engineering Technology Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Xiaofeng Ma
- Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, 7 Zhuanchang Road, Xining, 810012, China.
| | - Wenjing Zhao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Nanshan District, 1088 Xueyuan Avenue, Shenzhen, 518055, China.
| | - Xudong Liu
- School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, 510310, China.
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Duksal F, Eren F. Evaluation of thyroid functions and obesity in obstructive sleep apnea syndrome. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230376. [PMID: 37729367 PMCID: PMC10508951 DOI: 10.1590/1806-9282.20230376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE Obstructive sleep apnea syndrome is associated with many chronic diseases. METHODS Obesity and thyroid function tests were evaluated retrospectively and cross-sectionally for 782 obstructive sleep apnea syndrome patients. RESULTS The mean patient age was 49.3±11.5 years, and the majority were obese (67.9%) or overweight (26.6%). The mean age of the patients in Group 2 (moderate/severe obstructive sleep apnea syndrome) was higher than that of Group 1 (simple snoring/mild obstructive sleep apnea syndrome). The rate of severe obstructive sleep apnea syndrome among obese patients (35.2%) was significantly higher than that of normal-weight (11.6%) and overweight (18.3%) patients (p=0.001). The oxygen desaturation index/apnea-hypopnea index and levels of leukocytes and C-reactive protein were significantly higher, while mean/minimum saturation values and hemoglobin, hematocrit, and free triiodothyronine levels were significantly lower among obese patients compared with overweight and normal-weight patients (p=0.001). Leukocytes, C-reactive protein, and apnea-hypopnea index/oxygen desaturation index values were higher, and mean/minimum saturation values were lower in Group 2 than in Group 1. CONCLUSION There were relationships between obstructive sleep apnea syndrome severity and body mass index. Obesity could be a critical predisposing factor for sleep disturbances. The prevention and control of obesity is important while being treated for obstructive sleep apnea syndrome.
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Affiliation(s)
- Faysal Duksal
- Konya Beyhekim Research and Training Hospital, Department of Chest Diseases – Konya, Turkey
| | - Fettah Eren
- Selcuk University, Faculty of Medicine, Department of Neurology – Konya, Turkey
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Kim T, Kang J. Relationship between obstructive sleep apnea, insulin resistance, and metabolic syndrome: a nationwide population-based survey. Endocr J 2023; 70:107-119. [PMID: 36171092 DOI: 10.1507/endocrj.ej22-0280] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide population-based sample. A total of 7,900 adults with information on the STOP-Bang score and MetS (3,341 men and 4,469 women) were identified from the dataset of the Korea National Health and Nutrition Examination Survey 2019-2020. The association between OSA, IR, MetS, and its components was estimated using complex sample logistic regression analysis with adjustments for age, body mass index, residence, smoking status, alcohol consumption, household income, education, and the presence of diabetes. Participants with a high OSA score were more likely to have IR (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.96-3.95 in men and OR 2.64, 95% CI 0.55-12.80 in women), MetS (OR 6.05, 95% CI 4.23-8.69 in men and OR 4.20, 95% CI 1.23-15.70 in women), and components of MetS, compared to individuals with a low OSA score. Compared to premenopausal women, postmenopausal women had a more intense association between OSA and IR (OR 1.78, 95% CI 0.13-24.43 for premenopausal women and OR 3.64, 95% CI 0.60-22.28 for postmenopausal women) and MetS (OR 2.58, 95% CI 0.23-29.55 for premenopausal women and OR 5.36, 95% CI 1.42-20.21 for postmenopausal women). OSA was associated with abdominal obesity and hypertension in premenopausal women, while all components of MetS were associated with OSA in postmenopausal women. Further studies are necessary to elucidate the underlying mechanisms of these findings.
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Affiliation(s)
- Taeyun Kim
- Department of Internal Medicine, The Armed Forces Goyang Hospital, Goyang, Republic of Korea
| | - Jihun Kang
- Department of Family Medicine, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, Republic of Korea
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Wang D, Ren Y, Chen R, Zeng X, Gan Q, Zhuang Z, Su X, Wu K, Zhang S, Tang Y, Li S, Zhang H, Zhou Y, Zhang N, Zhao D. Establishment and Application Evaluation of an Improved Obstructive Sleep Apnea Screening Questionnaire for Chinese Community: The CNCQ-OSA. Nat Sci Sleep 2023; 15:103-114. [PMID: 36937783 PMCID: PMC10022442 DOI: 10.2147/nss.s396695] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/28/2023] [Indexed: 03/21/2023] Open
Abstract
Objective Obstructive sleep apnea (OSA) is a common sleep-disordered breathing disease. We aimed to establish an improved screening questionnaire without physical examinations for OSA named the CNCQ-OSA (Chinese community questionnaire for OSA). Methods A total of 2585 participants who visited sleep medicine center and underwent overnight polysomnography were grouped into two independent cohorts: derivation (n = 2180) and validation (n = 405). The CNCQ-OSA was designed according to the baseline of patients in derivation cohort. We comprehensively analyzed the data to evaluate the predictive value of the CNCQ-OSA, compared to the GOAL questionnaire, STOP-Bang questionnaire (SBQ) and NoSAS questionnaire. Results The CNCQ-OSA included seven variables: loud snoring, BMI ≥ 25 kg/m2, male gender, apnea, sleepiness, hypertension and age ≥30, with a total score ranging from 7 to 16.7 points (≥13.5 points indicating high risk of OSA, ≥14.5 points indicating extremely high risk). In the derivation and validation cohorts, the areas under the curve of the CNCQ-OSA were 0.761 and 0.767, respectively. In the validation cohort, the sensitivity and specificity of a CNCQ-OSA score ≥13.5 points for the apnea-hypopnea index (AHI) ≥5/h were 0.821 and 0.559, respectively (Youden index, 0.380), and the score ≥14.5 points were 0.494 and 0.887, respectively (Youden index, 0.375). The CNCQ-OSA had a better predictive value for AHI ≥ 5/h, AHI > 15/h and AHI > 30/h, with the highest Youden index, compared to the other questionnaires. Conclusion The CNCQ-OSA can effectively identify the risk of OSA, which is appropriate for self-screening at home without physical examinations.
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Affiliation(s)
- Donghao Wang
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Yingying Ren
- Medical Records and Statistics Room, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Riken Chen
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Xiangxia Zeng
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Qiming Gan
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Zhiyang Zhuang
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Xiaofen Su
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Kang Wu
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Sun Zhang
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Yongkang Tang
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Shiwei Li
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Haojie Zhang
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- The Clinical Medicine Department, Henan University, Zhengzhou, People’s Republic of China
| | - Yanyan Zhou
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Nuofu Zhang
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
| | - Dongxing Zhao
- State Key Laboratory of Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Correspondence: Dongxing Zhao; Nuofu Zhang, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Sleep Medicine Center, Guangzhou Institute of Respiratory Health, National Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China, Tel +86-13650901411; +86-13600460056, Email ;
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The value of nurse-led anthropometric and oropharyngeal measurements combined with STOP-Bang questionnaire in screening for obstructive sleep apnea in patients with acute coronary syndrome: a prospective cohort study. BMC Pulm Med 2022; 22:396. [PMCID: PMC9632106 DOI: 10.1186/s12890-022-02200-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Obstructive sleep apnea (OSA) is a modifiable risk factor for acute coronary syndrome (ACS), with high prevalence but low diagnostic rates. Therefore, it is particularly important to develop strategies for better screening for OSA in newly admitted ACS patients.
Methods
From March 2017 to October 2019, consecutive eligible patients with ACS underwent cardiorespiratory polygraphy during hospitalization. OSA was defined as an apnea–hypopnea index (AHI) ≥ 15 events/h. All anthropometric and oropharyngeal parameters are measured by specialist nurses.
Results
Finally, 761 ACS patients were recruited in the present study. Prevalence of moderate/severe OSA was 53.2% based on diagnostic criteria of AHI ≥ 15. Correlation analysis illustrated that AHI was positively correlated with anthropometric characteristics. In the multivariate model, only micrognathia (OR 2.02, 95% CI 1.02–4.00, P = 0.044), waist circumference (OR 1.08, 95% CI 1.04–1.11, P < 0.001), and STOP-BANG Questionnaire (SBQ) score (OR 1.45, 95% CI 1.27–1.66, P < 0.001) were independently associated with the prevalence of OSA. Receiver operating characteristic curve (ROC) analysis showed that the area under curve (AUC) of multivariable joint diagnosis (waist circumference, micrognathia combined with SBQ) was significantly better than the AUC of Epworth Sleepiness Scale (ESS) and SBQ (p < 0.0001 and p = 0.0002, respectively), and the results showed that AUC was 0.728. Under the optimal truncation value, the sensitivity was 73%, and the specificity was 61%, which was higher than the single index. Finally, we also constructed a nomogram model based on multiple logistic regression, to easily determine the probability of OSA in ACS patients.
Conclusions
The new screening tool has greater power than single questionnaire or measurements in screening of OSA among ACS patients.
Trial registration
Clinicaltrials.gov identifier NCT03362385, registered December 5, 2017.
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Su X, Li K, Yang L, Yang Y, Gao Y, Gao Y, Guo J, Lin J, Chen K, Han J, Liu L. Associations between abdominal obesity and the risk of stroke in Chinese older patients with obstructive sleep apnea: Is there an obesity paradox? Front Aging Neurosci 2022; 14:957396. [PMID: 36172486 PMCID: PMC9510899 DOI: 10.3389/fnagi.2022.957396] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background and purposeAbdominal obesity (AO) is a well-known independent risk factor for stroke in the general population although it remains unclear in the case of the elderly, especially in Chinese older patients with obstructive sleep apnea (OSA), considering the obesity paradox. This study aimed to investigate the association between AO and stroke among Chinese older patients with OSA.MethodsData were collected from January 2015 to October 2017, and 1,290 older patients (age 60–96 years) with OSA (apnea–hypopnea index ≥ 5 events/h on polysomnography) were consecutively enrolled from sleep centers at six hospitals, evaluated for AO defined as waist circumference (WC) using the standardized criteria for the Chinese population, and followed up prospectively for a median period of 42 months. Logistic regression and Cox regression analyses were used to determine the cross-sectional and longitudinal associations between AO and stroke risk in these participants and different groups of the severity of OSA.ResultsParticipants with AO had a higher prevalence of stroke at baseline. A higher incidence of stroke during a median follow-up period of 42 months in participants with AO than in participants without AO (12.4% vs. 6.8% and 8.3% vs. 2.4%, respectively; both P < 0.05) was predicted. Cross-sectional analysis revealed an association between AO and stroke (odds ratio [OR]1.96, 95% confidence interval [CI] 1.31–2.91), which was stronger among participants with moderate OSA only (OR 2.16, 95%CI 1.05–4.43). Cox regression analysis showed that, compared to participants without AO, participants with AO had a higher cumulative incidence of stroke (hazard ratio [HR] 2.16, 95% CI 1.12–4.04) during a median follow-up of 42 months, and this association was observed in patients with severe OSA only (HR 3.67, 95% CI 1.41–9.87) but not for individuals with mild OSA (HR = 1.84, 95% CI 0.43–6.23) and moderate OSA (HR = 1.98, 95% CI 0.73–6.45).ConclusionThe risk of stroke is associated with AO among Chinese older patients who have OSA, both at baseline and during follow-up, and the strength of the association varied by OSA severity. Active surveillance for early detection of AO could facilitate the implementation of stroke-preventive interventions in the Chinese older OSA population.
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Affiliation(s)
- Xiaofeng Su
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
- Sichuan College of Traditional Chinese Medicine, Mianyang, China
- Medical College, Yan’an University, Yan’an, China
| | - Kailiang Li
- Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Ling Yang
- Medical College, Yan’an University, Yan’an, China
| | - Yang Yang
- Medical College, Yan’an University, Yan’an, China
| | - Yinghui Gao
- PKU-UPenn Sleep Center, Peking University International Hospital, Beijing, China
| | - Yan Gao
- Department of General Practice, 960th Hospital of PLA, Jinan, China
| | - JingJing Guo
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Junling Lin
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Kaibing Chen
- Sleep Center, The Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
- *Correspondence: Lin Liu,
| | - Jiming Han
- Medical College, Yan’an University, Yan’an, China
- Jiming Han,
| | - Lin Liu
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
- Kaibing Chen,
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Smoking Obstructive Sleep Apnea: Arguments for a Distinctive Phenotype and a Personalized Intervention. J Pers Med 2022; 12:jpm12020293. [PMID: 35207781 PMCID: PMC8875333 DOI: 10.3390/jpm12020293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/31/2022] [Accepted: 02/11/2022] [Indexed: 02/01/2023] Open
Abstract
Background: This is the first study that aims to define smoking, with obstructive sleep apnea (OSA), as a phenotype (SOSA). Moreover, we wanted to demonstrate the deleterious effects of the continuation of smoking on OSA. Methods: The cross-sectional study highlighted four dimensions of SOSA: the demographic and anthropometric features, the symptoms, the comorbidities, and the sleep study parameters. This study compared these characteristics between current smokers (CS), those who have never smoked (NS), and ex-smokers (ES) with OSA. Results: More men (83.95% in CS, versus 66.67% in NS) and an earlier onset of OSA (average age = 50.05 in CS, versus 52.26 in NS, p = 0.04) were recorded among CS. The distinguishing symptom of CS was daytime sleepiness, with an Epworth score that was significantly higher than in NS. Chronic obstructive pulmonary disease (COPD) was significantly more prevalent in CS (38.27%) than in NS (1.51%) (p < 0.001). The severity of OSA, consisting of a higher apnea-hypopnea index, a higher oxygen desaturation index, and a longer time spent below 90% oxygen saturation during sleep was significantly influenced by smoking. Conclusions: The SOSA phenotype includes younger male patients with a higher waist circumference, suggesting central obesity. They have a higher prevalence of COPD and a greater severity of OSA, in correlation with the number of pack-years of smoking.
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Roux-en-Y Versus One Anastomosis Gastric Bypass as Redo-Operations Following Sleeve Gastrectomy: A Retrospective Study. World J Surg 2022; 46:855-864. [PMID: 34985543 DOI: 10.1007/s00268-021-06424-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Aim of this study was to improve knowledge about the best conversional bariatric procedure following sleeve gastrectomy (SG). METHODS Data of conversional Roux-en-Y gastric bypass (RYGB) and of one anastomosis gastric bypass (OAGB) after SG were collected prospectively and analyzed retrospectively. Weight loss parameters, gastroesophageal reflux disease (GERD) and comorbidities outcomes were recorded. RESULTS Total of 123 patients (90 female, mean age 44 ± 0.9 years, mean body mass index (BMI) 42 ± 0.8 kg/m2) had either RYGB (n = 68) or OAGB (n = 55). Perioperative mortality was zero. Mean surgery time was significantly shorter for OAGB (168 ± 7.2 vs. 201 ± 6.8 min). Perioperative complication rates were not significantly (ns) different between RYGB and OAGB. Total body weight loss (TBWL) in RYGB and OAGB was 18 ± 2.2% and 18 ± 1.9% (12 months) and 18 ± 3.0% and 23 ± 2.6% (24 months; ns), respectively. Length of (individualized) biliopancreatic limb (BPL) correlated significantly with weight loss. Remission rates after 12 months of RYGB and OAGB for arterial hypertension (aHt) were 89% and 92%, for obstructive sleep apnea (OSAS) 56% and 82%, for Type 2 diabetes mellitus (T2DM) 100% and 92%, for osteoarthritis 64% and 85% and for GERD 89% versus 87% (ns), respectively. Nutritional deficiencies were comparable in RYGB (n = 11) and OAGB (n = 14) group (ns). CONCLUSION Both RYGB and OAGB are effective conversional procedures after SG, leading to comparable TBWL, BMI-loss and high remission rates of comorbidities including GERD. Significantly shorter operation times were in favor of OAGB. BPL, which was longer in OAGB was significantly related to higher %TBWL and %BMI-loss compared to RYGB.
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15
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Li J, Lv Q, Sun H, Yang Y, Jiao X, Yang S, Yu H, Qin Y. Combined Association Between ADIPOQ, PPARG, and TNF Genes Variants and Obstructive Sleep Apnea in Chinese Han Population. Nat Sci Sleep 2022; 14:363-372. [PMID: 35264890 PMCID: PMC8901229 DOI: 10.2147/nss.s343205] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 02/09/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Obstructive sleep apnea (OSA) is a common chronic polygenic disease. Multiple genetic markers associated with OSA have been identified by genome-wide association studies. Here, we aimed to construct a polygenic risk score (PRS) and examine the association with the presence of OSA in a Chinese Han Population. PATIENTS AND METHODS This study included 1057 individuals who were genotyped for nine susceptibility loci from three genes (ADIPOQ, PPARG, and TNF), from which each individual's PRS was calculated by summing the number of risk alleles. The associations between PRS and OSA were determined by logistic regression analyses. Model discrimination was assessed by a receiver operating characteristic (ROC) curve using bootstrapping with 1000 resamples. RESULTS The subjects included 874 with OSA and 183 controls. A higher PRS was associated with an increased apnea-hypopnea index (AHI). The PRS was an important risk factor for the development of OSA (OR = 1.237 per SD, P = 0.030). Subjects with higher PRS had a 2.88-fold (95% CI: 1.393-5.955, P = 0.004) and 5.402-fold (95% CI: 2.311-12.624, P<0.001) greater risk for having OSA and moderate-to-severe OSA, respectively, compared with those with lower genetic risk. More importantly, compared with determination of risk based solely on clinical factors, addition of the PRS increased discriminatory accuracy for both OSA (AUC from 0.75 to 0.78, P = 0.02) and moderate-to-severe OSA (AUC from 0.80 to 0.83, P = 0.02). CONCLUSION Our study suggests that the PRS is independently associated with AHI and OSA. Combining PRS with conventional risk factors could improve the discrimination of OSA.
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Affiliation(s)
- Juan Li
- Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, People's Republic of China.,Emergency Department, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
| | - Qianwen Lv
- Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, People's Republic of China
| | - Haili Sun
- Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, People's Republic of China
| | - Yunyun Yang
- Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, People's Republic of China.,Key Laboratory of Remodeling-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, 100029, People's Republic of China
| | - Xiaolu Jiao
- Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, People's Republic of China.,Key Laboratory of Remodeling-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, 100029, People's Republic of China
| | - Song Yang
- Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, People's Republic of China
| | - Huahui Yu
- Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, People's Republic of China.,Key Laboratory of Remodeling-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, 100029, People's Republic of China
| | - Yanwen Qin
- Key Laboratory of Upper Airway Dysfunction-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, 100029, People's Republic of China.,Key Laboratory of Remodeling-related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, 100029, People's Republic of China
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Bikov A, Frent S, Reisz D, Negru A, Gaita L, Breban Schwarzkopf D, Mihaicuta S. Comparison of Composite Lipid Indices in Patients with Obstructive Sleep Apnoea. Nat Sci Sleep 2022; 14:1333-1340. [PMID: 35923809 PMCID: PMC9342428 DOI: 10.2147/nss.s361318] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/21/2022] [Indexed: 12/02/2022] Open
Abstract
PURPOSE Obstructive sleep apnoea (OSA) is a recognised risk factor for cardiovascular disease. However, it is difficult to evaluate the risk of cardiovascular disease in patients with OSA due to multiple shared risk factors. Composite lipid indices, such as atherogenic index of plasma (AIP), visceral adiposity index (VAI) and lipid accumulation product (LAP) have been shown to predict cardiovascular disease better than their individual lipid components. This study aimed to evaluate these indices in patients with OSA. PATIENTS AND METHODS Six hundred sixty-seven (667) patients with OSA and 139 non-OSA control volunteers participated in the study. Fasting serum triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C) levels were measured, and AIP, LAP and VAI were calculated following cardiorespiratory polygraphy. The relationship between lipid parameters, OSA and its comorbidities was evaluated using receiver operating curve (ROC) analysis. RESULTS We found a significant difference in all lipid parameters between OSA patients and controls. Comparing ROCs, LAP was significantly more strongly associated with OSA compared to all the other parameters. The optimal cut-off value for LAP to detect OSA was 76.4, with a sensitivity of 63% and a specificity of 76%. In addition, LAP was the best parameter to predict hypertension and diabetes in patients with OSA, and it was predictive for ischaemic heart disease together with HDL-C. CONCLUSION Our results support the use of LAP in clinical practice when evaluating cardiovascular risk in patients with OSA. However, the optimal cut-off value should be determined in large-scale follow-up studies.
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Affiliation(s)
- Andras Bikov
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Immunology, Immunity to Infection and Respiratory Medicine, University of Manchester, Manchester, UK
| | - Stefan Frent
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, Department of Pulmonology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Daniela Reisz
- Department of Neurology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Alina Negru
- Department of Cardiology (II), "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania.,Department of Clinical Research, Institute of Cardiovascular Diseases, Timisoara, Romania
| | - Laura Gaita
- Second Department of Internal Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Daniel Breban Schwarzkopf
- Department of Anatomy, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Stefan Mihaicuta
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, Department of Pulmonology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Timisoara, Romania
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Jin H, He J, Dong C, Li B, Ma Z, Li B, Huang T, Fan J, He G, Zhao X. Altered Lipid Profile Is a Risk Factor for the Poor Progression of COVID-19: From Two Retrospective Cohorts. Front Cell Infect Microbiol 2021; 11:712530. [PMID: 34660338 PMCID: PMC8515140 DOI: 10.3389/fcimb.2021.712530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/25/2021] [Indexed: 12/29/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has spread worldwide. However, the impact of baseline lipid profile on clinical endpoints in COVID-19 and the potential effect of COVID-19 on lipid profile remain unclear. Methods In this retrospective cohort study, we consecutively enrolled 430 adult COVID-19 patients from two Chinese hospitals (one each in Chengdu and Wuhan). The lipid profile before admission and during the disease course and the clinical endpoint including in-hospital death or oropharyngeal swab test positive again (OSTPA) after discharge were collected. We used Kaplan-Meier and Cox regression to explore the lipid risk factors before admission associated with endpoints. Then, we assessed the lipid level change along with the disease course to determine the relationship between pathology alteration and the lipid change. Results In the Chengdu cohort, multivariable Cox regression showed that low-density lipoprotein cholesterol (LDL-C) dyslipidemia before admission was associated with OSTPA after discharge for COVID-19 patients (RR: 2.51, 95% CI: 1.19, 5.29, p = 0.006). In the Wuhan cohort, the patients with triglyceride (TG) dyslipidemia had an increased risk of in-hospital death (RR: 1.92, 95% CI: 1.08, 3.60, p = 0.016). In addition, in both cohorts, the lipid levels gradually decreased in the in-hospital death or OSTPA subgroups since admission. On admission, we also noticed the relationship between the biomarkers of inflammation and the organ function measures and this lipid level in both cohorts. For example, after adjusting for age, sex, comorbidities, smoking, and drinking status, the C-reactive protein level was negatively associated with the TC lipid level [β (SE) = -0.646 (0.219), p = 0.005]. However, an increased level of alanine aminotransferase, which indicates impaired hepatic function, was positively associated with total cholesterol (TC) lipid levels in the Chengdu cohort [β (SE) = 0.633 (0.229), p = 0.007]. Conclusions The baseline dyslipidemia should be considered as a risk factor for poor prognosis of COVID-19. However, lipid levels may be altered during the COVID-19 course, since lipidology may be distinctly affected by both inflammation and organic damage for SARS-CoV-2.
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Affiliation(s)
- Hui Jin
- Department of Otolaryngology, Wuhan Third Hospital, Wuhan, China
| | - Junji He
- Department of Otolaryngology Head and Neck Surgery, Public Health Clinical Center of Chengdu, Chengdu, China
| | - Chuan Dong
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Bin Li
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiyue Ma
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Bilan Li
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Tiande Huang
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiangang Fan
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Gang He
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaolong Zhao
- Department of Otolaryngology Head and Neck Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
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Su L, Xiao Y. Application of personalized medicine to obstructive sleep apnea in China. Sleep Med 2021; 87:22-29. [PMID: 34508984 DOI: 10.1016/j.sleep.2021.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 07/15/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
Obstructive sleep apnea (OSA) is a common sleep disorder whose prevalence is increasing in China consistent with rising obesity trends. OSA is a heterogeneous disorder depends on anatomical and nonanatomical risk factors. Ethnicity differentially influences the attribution of these OSA risk factors. Chinese patients had more craniofacial bony restriction and Caucasians were more obese. This suggests ethnic differences in potential applications for diagnostics and therapeutics. However, current strategies for the management of OSA reflect a one-size-fits-all approach based on the apnea-hypopnea index (AHI). Although continuous positive airway pressure (CPAP) remains the first-line and most efficacious treatment for OSA, the acceptance is unacceptably low in China. Therefore, targeted therapies to treat OSA need to be developed. This review summarizes the differences in OSA pathogenesis of Chinese patients and analyzes the current condition of personalized medicine to patients with OSA in China. The application of personalized medicine to OSA in the Chinese population is still a long way off.
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Affiliation(s)
- Linfan Su
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Yi Xiao
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
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Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers. Sleep Breath 2021; 26:743-751. [PMID: 34338952 DOI: 10.1007/s11325-021-02446-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Data on the validity of tools for sleep apnea risk detection in rotating shift workers are limited. The aim was to evaluate the Berlin questionnaire (BQ) and the Neck, Obesity, Snoring, Age, Sex (NoSAS) score for the detection of obstructive sleep apnea risk in shift workers. METHODS This cross-sectional study included male rotating shift workers, drivers of heavy off-road machinery in an iron ore extraction company. Polysomnography was the gold standard for evaluation. Obstructive sleep apnea (OSA) was defined as an apnea-hypopnea index (AHI) of ≥ 5 events/h. The Shapiro-Wilk test verified the data distribution and comparative analysis was conducted using the chi-square analyses and U Mann-Whitney with Bonferroni correction. Receiver operating characteristic curve analysis, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy were used for evaluate BQ and NoSAS with OSA diagnosis by polysomnograph. RESULTS Among 119 male shift workers, ages 24 to 57 years, polysomnography showed that 84% had obstructive sleep apnea (AHI ≥ 5), and 46% had moderate to severe sleep apnea (AHI ≥ 15). For AHI ≥ 5, the NoSAS score had higher sensitivity and specificity than the BQ. For AHI ≥ 15 and AHI ≥ 30, the NoSAS score had a sensitivity higher than 70% while BQ was 60% and 58%, respectively. The accuracy of the NoSAS score was higher for all OSA criteria than that of BQ. CONCLUSION In rotating shift workers, drivers of heavy off-road machinery, the NoSAS score showed higher accuracy in identifying patients at risk for sleep apnea than the BQ.
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20
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Jiang Z, Qin J, Liang K, Zhao R, Yan F, Hou X, Wang C, Chen L. Self-reported snoring is associated with chronic kidney disease in obese but not in normal-weight Chinese adults. Ren Fail 2021; 43:709-717. [PMID: 33896382 PMCID: PMC8079005 DOI: 10.1080/0886022x.2021.1915332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The relationship between sleeping disorders and chronic kidney disease (CKD) has already been reported. Snoring, a common clinical manifestation of obstructive sleep apnea–hypopnea syndrome, is of clinical value in assessing sleeping disorder severity. However, investigations of the connection between snoring and CKD are limited, especially in normal-weight populations. This study assessed the relationship between snoring frequency and CKD in obese and normal-weight people in China. Methods A community-based retrospective cross-sectional study of 3250 participants was performed. Study participants were divided into three groups – the regularly snoring group, occasionally snoring group, and never snoring group – based on their self-reported snoring frequency. CKD was defined as an estimated glomerular filtration rate of less than 60 mL/min/1.73 m2. Multiple logistic regression analysis was used to explore the relevance between snoring frequency and CKD prevalence. Results The CKD prevalence in obese participants was higher than that in normal-weight participants. Frequent snorers had a higher prevalence of CKD than those who were not frequent snorers in the obese group. Snoring frequency was correlated with CKD prevalence in obese participants independent of age, sex, smoking and drinking status, systolic blood pressure, triglyceride level, high-density lipoprotein, and homeostasis model assessment of insulin resistance (odds ratio: 2.66; 95% CI: 1.36–5.19; p=.004), while the same relationships did not exist in normal-weight participants (odds ratio: 0.79; 95% CI: 0.32–1.98; p=.614). Conclusions Snoring appears to be independently associated with CKD in obese but not in normal-weight Chinese adults.
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Affiliation(s)
- Ziyun Jiang
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Jun Qin
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Kai Liang
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Ruxing Zhao
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Fei Yan
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Xinguo Hou
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Chuan Wang
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
| | - Li Chen
- Department of Endocrinology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Endocrine and Metabolic Diseases of Shandong University, Jinan, China.,Key Laboratory of Endocrine and Metabolic Diseases, Shandong Province Medicine & Health, Jinan, China.,Jinan Clinical Research Center for Endocrine and Metabolic Diseases, Jinan, China
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21
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Wei R, Gao Z, Xu H, Jiang C, Li X, Liu Y, Zou J, Zhu H, Yi H, Guan J, Yin S. Body Fat Indices as Effective Predictors of Insulin Resistance in Obstructive Sleep Apnea: Evidence from a Cross-Sectional and Longitudinal Study : BFI as Predictors of IR in OSA. Obes Surg 2021; 31:2219-2230. [PMID: 33569729 DOI: 10.1007/s11695-021-05261-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE Body fat indices serve as predictive markers of insulin resistance (IR) in metabolic diseases. IR is common in obstructive sleep apnea (OSA). However, whether body fat indices have utility as predictors of IR in OSA remain unknown. MATERIALS AND METHODS A longitudinal study was conducted in 46 patients undergoing bariatric surgery to explore the relationship between IR and body fat indices. Then, a cross-sectional study was performed to evaluate the relationships between body fat indices and IR, and receiver operating characteristic (ROC) curves were generated. Body indices, homeostasis model assessment index of insulin resistance (HOMA-IR), biological indicators, and polysomnographic variables were collected. RESULTS In the longitudinal study, significant relationships were found between remission of IR and changes in visceral adiposity index (VAI) (r = 0.452, P < 0.05) and triglyceride-glucose index (TyG) (r = 0.650, P < 0.01). In the cross-sectional study, lipid accumulation product (LAP) (best cutoff value: 30.16, area under the curve (AUC) = 0.728, P < 0.001) and TyG (best cutoff value: 8.54, AUC = 0.740, P < 0.001) were indicators of IR in normal weight group. In overweight/obese group, body mass index (BMI) (best cutoff value: 27.69 AUC = 0.707, P < 0.001) and waist circumference (WC) (best cutoff value: 97.25, AUC = 0.708, P < 0.001) were markers of IR. TyG showed better ability to predict IR in normal weight females (best cutoff value: 8.39 AUC = 0.813, P < 0.001). CONCLUSIONS Body fat indices are predictive markers of IR in patients with OSA.
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Affiliation(s)
- Ruobing Wei
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China
| | - Zhenfei Gao
- Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China
| | - Huajun Xu
- Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China.
| | | | - Xinyi Li
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China
| | - Yupu Liu
- Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China
| | - Jianyin Zou
- Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China
| | - Huaming Zhu
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China
| | - Hongliang Yi
- Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China
| | - Jian Guan
- Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China.
| | - Shankai Yin
- Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Road 600, Shanghai, 200233, China
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Gu M, Huang W, Li X, Liu Y, Wang F, Fang C, Chen T. Association of Hypertriglyceridemic Waist Phenotype with Obstructive Sleep Apnea: A Cross-Sectional Study. Nat Sci Sleep 2021; 13:2165-2173. [PMID: 34955662 PMCID: PMC8694710 DOI: 10.2147/nss.s335288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 12/06/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Hypertriglyceridemic waist (HTGW) phenotype is an independent risk factor for metabolic disorders. Although obstructive sleep apnea (OSA) is associated with metabolic disorders, it is unclear whether there is an association between HTGW phenotype and OSA. METHODS We enrolled consecutive participants presenting to a sleep center in Shanghai, China. Full-night polysomnography was performed, and serum triglyceride (TG) levels and waist circumference (WC) were calculated. HTGW phenotype was defined as increased WC (men > 90 cm, women > 80 cm) and elevated TG levels (> 1.7 mmol/L). Participants were classified into four groups: normal TG with normal WC (NTNW); normal TG with increased WC (NTGW); elevated TG with normal WC (HTNW); and elevated TG with enlarged WC, namely HTGW. The relationships between HTGW phenotypes and OSA were assessed using binary (apnea hypopnea index, [AHI]≥5/hr) and multinomial logistic regression analyses (clinical AHI severity categories). RESULTS We included 3190 participants in this cross-sectional study. Compared to the NTNW phenotype, participants with NTGW and HTGW phenotypes had the significantly higher risk of OSA (AHI ≥5/hr, odds ratio [OR] = 2.51, 95% confidence interval [CI] = 1.91-3.31; OR = 3.76, 95% CI = 2.67-5.31, respectively), after adjustment for confounders. In subgroup analyses categorised by age, sex, and BMI, the aforementioned associations remained significant. The association between the NTGW, HTGW phenotype and OSA risk remained significant across the OSA severity groups. Multinomial logistic regression also revealed that the mild (OR = 1.63, 95% CI = 1.07-2.50), moderate (OR = 1.875, 95% CI = 1.22-2.88), and severe OSA (OR = 3.18, 95% CI = 2.14-4.73) were associated with HTGW phenotype. CONCLUSION Both NTGW and HTGW phenotype were positively associated with OSA risk in all subgroups. Further longitudinal follow-up studies are needed to determine the causal link and prognostic role of these metabolic factors.
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Affiliation(s)
- Meizhen Gu
- Department of Otolaryngology-Head & Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China
| | - Weijun Huang
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Xinyi Li
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Yupu Liu
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Fan Wang
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Chao Fang
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Otolaryngology-Head & Neck Surgery, The First Hospital of Putian, Putian, Fujian Province, People's Republic of China
| | - Ting Chen
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People's Republic of China.,Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
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23
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Huang W, Zhong A, Xu H, Xu C, Wang A, Wang F, Li X, Liu Y, Zou J, Zhu H, Zheng X, Yi H, Guan J, Yin S. Metabolomics Analysis on Obesity-Related Obstructive Sleep Apnea After Weight Loss Management: A Preliminary Study. Front Endocrinol (Lausanne) 2021; 12:761547. [PMID: 35046891 PMCID: PMC8761762 DOI: 10.3389/fendo.2021.761547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 12/09/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Roux-en-Y gastric bypass (RYGB) surgery is an effective type of weight loss management and may improve obesity-related obstructive sleep apnea (OSA). Obese subjects who meet the criteria for surgery with OSA were enrolled. We investigated the metabolomic effects of RYGB on OSA. METHODS Clinical data, serum measurements including indices of glycolipid metabolism, and polysomnography (PSG) measurements were collected at baseline and 6 months after RYGB surgery. Metabolomic analysis was performed using ultra-performance liquid chromatography-mass spectrometry. RESULTS A group of 37 patients with obesity, type 2 diabetes (T2DM) and suspected OSA were enrolled of which 27 were OSA subjects. After RYGB surgery, metabolic outcomes and sleep parameters were all significantly improved. The OSA remission group had lower valine, isoleucine, and C24:1(cis-15) levels, and higher trimethylamine N-oxide, hippurate, and indole-3-propionic acid levels after RYGB surgery. A combination of preoperative indices (age, apnea-hypopnea index (AHI), fasting C-peptide level, and hippurate level) predicted the RYGB effect size in obese patients with T2DM and OSA, with an area under receiver operating characteristic curve of 0.947, specificity of 82.4%, and sensitivity of 100%. CONCLUSIONS RYGB surgery may significantly improve the metabolic status of patients with obesity, T2DM and OSA. A combination of preoperative indices (age, AHI, fasting C peptide level, and hippurate level) may be useful for predicting the effect size of RYGB in obese patients with T2DM and OSA. The mechanisms underlying OSA remission need to be explored.
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Affiliation(s)
- Weijun Huang
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Anyuan Zhong
- Department of Respiratory Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Huajun Xu
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Hongliang Yi, ; Xiaojiao Zheng, ; Huajun Xu,
| | - Chong Xu
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Anzhao Wang
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Fan Wang
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Xinyi Li
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yupu Liu
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Jianyin Zou
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Huaming Zhu
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Xiaojiao Zheng
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Hongliang Yi, ; Xiaojiao Zheng, ; Huajun Xu,
| | - Hongliang Yi
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Hongliang Yi, ; Xiaojiao Zheng, ; Huajun Xu,
| | - Jian Guan
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Shankai Yin
- Department of Otorhinolaryngology Head and Neck Surgery and Otolaryngology Institute of Shanghai Jiao Tong University and Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
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Gao D, Li Y, Yang Z, Ma Y, Chen M, Dong Y, Zou Z, Ma J. The Association Between Single-Child Status and Risk of Abdominal Obesity: Result From a Cross-Sectional Study of China. Front Pediatr 2021; 9:697047. [PMID: 34490158 PMCID: PMC8417322 DOI: 10.3389/fped.2021.697047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/19/2021] [Indexed: 01/17/2023] Open
Abstract
Background: Obesity has become a serious problem threatening the health of children and adolescents, and China's one-child policy has affected family structure and parenting practice, which may result in several adverse health outcomes. The present study aims to investigate the association between single-child status and the risk of abdominal obesity in Chinese adolescents and also to compare the differences in the risk of unideal energy-related behaviors. Methods: Data were obtained from a school-based cross-sectional survey conducted in seven provinces of China, in 2012. A total of 31,291 students aged 7-17 years were recruited in this study. Anthropometric measurements were conducted to assess height and waist circumference, and questionnaires were used to obtain information of single-child status, parental educational attainment, parental weight status, and offspring energy-related behaviors. Multivariate logistic regression models were used to estimate the odds ratio (OR) and 95% confidence intervals (95% CI) of single-child status and odds of childhood abdominal obesity and energy-related behaviors. Results: The prevalence of abdominal obesity was 18.2% in single children, which was higher than that of non-single children (13.7%). The prevalence was also higher in single children in different sex and residence subgroups. Logistic regression models showed that single children had 1.33 times (OR: 1.33, 95% CI: 1.24-1.43, P < 0.001) higher odds of abdominal obesity compared to non-single children. Single children had 1.08 times higher odds of physical inactivity (OR: 1.08, 95% CI: 1.03-1.14, P = 0.004), 1.13 times higher odds of excessive sugar-sweetened beverages (SSBs) consumption (OR: 1.13, 95% CI: 1.05-1.23, P = 0.002), and 1.08 times more likely to eat out (OR: 1.08, 95% CI: 1.02-1.13, P = 0.006). Those associations were more remarkable in single girls. Conclusion: Being a single child may be associated with a higher odds of childhood abdominal obesity and unhealthy energy-related behaviors. Future interventions and strategies to prevent abdominal obesity should focus on this high-risk population.
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Affiliation(s)
- Di Gao
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yanhui Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Zhaogeng Yang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Ying Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.,Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
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Impact of CPAP treatment for obstructive sleep apnea on visceral adipose tissue: a meta-analysis of randomized controlled trials. Sleep Breath 2020; 25:555-562. [PMID: 32857319 DOI: 10.1007/s11325-020-02181-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/15/2020] [Accepted: 08/21/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND It is still controversial if the continuous positive airway pressure (CPAP) treatment for patients with obstructive sleep apnea (OSA) can markedly influence an effect on visceral adipose tissue (VAT). The current study aimed to assess the efficacy of CPAP interventions in reducing VAT in OSA patients. METHODS The Web of Science, PubMed, Embase, and Cochrane Library (up to December, 2019) were searched for randomized trials that assessed the effect of CPAP therapy in decreasing VAT in OSA patients. Information on the study, pre- and post-CPAP treatment of VAT, and patient characteristics were extracted for analysis. The standardized mean difference (SMD) was applied to measure the summary estimates. The analysis was conducted with STATA 13.0 and RevMan v.5.3. RESULTS Five studies (6 cohorts) that involved 169 patients were enrolled in the meta-analysis. There was no significant change of VAT in patients with OSA before and after CPAP treatment (SMD = - 0.00, 95% CI = - 0.21 to 0.21, z = 0.01, p = 0.99). Subgroup analyses further demonstrated that the results were not influenced by CPAP therapy duration, patient age, sample size, or baseline body mass index. CONCLUSIONS Among the patients with OSA, our meta-analysis revealed that treatment with CPAP does not significantly lead to a reduction of VAT. High-quality randomized controlled trials may provide further clarifying information.
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Liu Y, Zou J, Qian Y, Xu H, Zhu H, Meng L, Guan J, Yi H, Yin S. The association between obesity indices and obstructive sleep apnea is modified by age in a sex-specific manner. Sleep Breath 2020; 25:189-197. [PMID: 32367469 DOI: 10.1007/s11325-020-02083-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 04/01/2020] [Accepted: 04/06/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND The beneficial effects of weight reduction on obstructive sleep apnea (OSA) are highly variable. Whether or not the variability is associated with the effects of age and sex remains unclear. This study examined this issue with large cross-sectional data. METHOD Anthropometric measurements, polysomnographic variables, biochemical indicators, and medical history were collected for each participant. Multivariable linear regression with interaction terms was used to estimate the modification effect of age on the associations between OSA severity (assessed by apnea-hypopnea index, AHI) with obesity indices (body mass index, BMI; neck circumference, NC; waist circumference, WC; waist-to-hip ratio, WHR) in a sex-specific manner, and vice versa. To facilitate interpretation of the results, participants were further classified into six subpopulations according to both sex and age, and population-specific beta-coefficients were calculated and compared. RESULTS A total of 5756 adults (4600 men) with suspected OSA were included in the study. BMI, NC, WC, and WHR were all positively correlated with AHI after adjusting for potential confounders in all populations. In men, these associations were much stronger and more significant in younger than older individuals (P for interaction < 0.001). For example, a 10% increase in BMI was independently associated with a 32% increase in AHI for men < 40 years old, whereas the corresponding increases were 21% and 17% for men 40-60 and > 60 years old, respectively. By contrast, no modification effect of age was observed in women (P for interaction > 0.05). A 10% increase in BMI was associated with 26%, 27%, and 24% increases in AHI for women < 40, 40-60, and > 60 years old, respectively. CONCLUSIONS Age modifies the associations between obesity indices and OSA severity in a sex-specific manner. These findings may broaden the understanding of age- and sex-related heterogeneities in the pathogenic role of obesity in OSA, and may be beneficial for individualized risk evaluation and treatment management for patients with OSA.
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Affiliation(s)
- Yupu Liu
- Therapy Center of Obstructive Sleep Apnea, Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Jianyin Zou
- Therapy Center of Obstructive Sleep Apnea, Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Yingjun Qian
- Therapy Center of Obstructive Sleep Apnea, Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Huajun Xu
- Therapy Center of Obstructive Sleep Apnea, Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Huaming Zhu
- Therapy Center of Obstructive Sleep Apnea, Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Lili Meng
- Therapy Center of Obstructive Sleep Apnea, Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Jian Guan
- Therapy Center of Obstructive Sleep Apnea, Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, China.
- Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China.
| | - Hongliang Yi
- Therapy Center of Obstructive Sleep Apnea, Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, China.
- Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China.
| | - Shankai Yin
- Therapy Center of Obstructive Sleep Apnea, Department of Otorhinolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, China
- Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
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Efficacy of continuous positive airway pressure on subcutaneous adipose tissue in patients with obstructive sleep apnea: a meta-analysis of randomized controlled trials. Sleep Breath 2020; 25:1-8. [PMID: 32333260 DOI: 10.1007/s11325-020-02078-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/22/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE It remains inconclusive whether continuous positive airway pressure (CPAP) therapy can significantly reduce subcutaneous adipose tissue (SAT) in patients with obstructive sleep apnea (OSA). This meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the impact of CPAP treatment on SAT in patients with OSA. METHODS We searched Pubmed, Cochrane, Web of Science, and Embase for RCTs, which investigated the effectiveness of CPAP treatment in reducing SAT among patients with OSA. Following the PRISMA guidelines, we extracted information on the study and patient characteristics, and pre- and post-CPAP measures of SAT. We then calculated the overall effects using the standardized mean difference (SMD) with a 95% confidence interval (CI). RESULTS A total of 5 RCTs (comprising 153 patients) met inclusion criteria for the meta-analysis. We found that the SAT did not change before and after CPAP treatment in patients with OSA (SMD = - 0.02, 95% CI - 0.25 to 0.2, z = 0.19, p = 0.85). Subgroup analyses indicated that the outcome was not affected by age, CPAP therapy duration, baseline body mass index, and measure utilized. CONCLUSION This meta-analysis of RCTs suggests that CPAP therapy does not significantly decrease the level of SAT among patients with OSA. Further large-scale, and high-quality randomized controlled trials are needed to better address this issue.
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