Xiaolong Zhao1,2,3,4, Huajun Xu1,2,3,4, Yingjun Qian1,2,3,4, Yupu Liu1,2,3,4, Juanjuan Zou1,2,3,4, Hongliang Yi1,2,3,4, Jian Guan5,6,7,8, Shankai Yin9,10,11,12. 1. Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600# Yishan Road, Shanghai, 200233, China. 2. Otolaryngological Institute, Shanghai Jiao Tong University, Shanghai, China. 3. Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 4. Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China. 5. Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600# Yishan Road, Shanghai, 200233, China. guanjian0606@sina.com. 6. Otolaryngological Institute, Shanghai Jiao Tong University, Shanghai, China. guanjian0606@sina.com. 7. Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. guanjian0606@sina.com. 8. Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China. guanjian0606@sina.com. 9. Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600# Yishan Road, Shanghai, 200233, China. skyin@sjtu.edu.cn. 10. Otolaryngological Institute, Shanghai Jiao Tong University, Shanghai, China. skyin@sjtu.edu.cn. 11. Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. skyin@sjtu.edu.cn. 12. Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China. skyin@sjtu.edu.cn.
Abstract
BACKGROUND: Previous studies have reported that obesity can result in or worsen obstructive sleep apnea (OSA). However, whether abdominal or general obesity indices or visceral adiposity indicators have a stronger association with OSA remains unclear. METHODS: This cross-sectional study included 4344 patients who underwent polysomnography (PSG) due to suspicion of OSA. We also performed a longitudinal study on 86 patients who underwent bariatric surgery to confirm the relationship between OSA and obesity. Data on overnight PSG parameters, biochemical biomarkers, and multiple anthropometric obesity indices were collected. RESULTS: In the cross-sectional study, waist circumference (WC) and body mass index (BMI) were independently associated with the apnea-hypopnea index (AHI) after adjusting for potential confounding factors (additional R2 = 0.232, standardized beta coefficient [Beta] = 0.210; and additional R2 = 0.015, Beta = 0.183, respectively). Logistic regression analysis showed similar results, as did stratified analysis of adult males aged ≤ 55 years. Restricted cubic spline (RCS) analysis revealed a linear dose-response relationship between OSA and obesity. In the longitudinal study, no significant relationship was found between remission of OSA and improvement in WC and BMI (r = 0.252, p = 0.098; and r = 0.132, p = 0.395, respectively), whereas the change in the visceral adiposity indicator (lipid accumulation calculated according to WC and fasting triglycerides) was significantly correlated with ΔAHI (r = 0.322, p = 0.033). CONCLUSIONS: Abdominal obesity, rather than general obesity, appears to play a more important role in OSA.
BACKGROUND: Previous studies have reported that obesity can result in or worsen obstructive sleep apnea (OSA). However, whether abdominal or general obesity indices or visceral adiposity indicators have a stronger association with OSA remains unclear. METHODS: This cross-sectional study included 4344 patients who underwent polysomnography (PSG) due to suspicion of OSA. We also performed a longitudinal study on 86 patients who underwent bariatric surgery to confirm the relationship between OSA and obesity. Data on overnight PSG parameters, biochemical biomarkers, and multiple anthropometric obesity indices were collected. RESULTS: In the cross-sectional study, waist circumference (WC) and body mass index (BMI) were independently associated with the apnea-hypopnea index (AHI) after adjusting for potential confounding factors (additional R2 = 0.232, standardized beta coefficient [Beta] = 0.210; and additional R2 = 0.015, Beta = 0.183, respectively). Logistic regression analysis showed similar results, as did stratified analysis of adult males aged ≤ 55 years. Restricted cubic spline (RCS) analysis revealed a linear dose-response relationship between OSA and obesity. In the longitudinal study, no significant relationship was found between remission of OSA and improvement in WC and BMI (r = 0.252, p = 0.098; and r = 0.132, p = 0.395, respectively), whereas the change in the visceral adiposity indicator (lipid accumulation calculated according to WC and fasting triglycerides) was significantly correlated with ΔAHI (r = 0.322, p = 0.033). CONCLUSIONS:Abdominal obesity, rather than general obesity, appears to play a more important role in OSA.
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