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Chaudhary P, Goyal A, Pakhare A, Goel SK, Kumar A, Reddy MA, Anoohya V. Metabolic syndrome in non-obese patients with OSA: learning points of a cross-sectional study from a tertiary care hospital in Central India. Sleep Breath 2021; 26:681-688. [PMID: 34283339 PMCID: PMC8289879 DOI: 10.1007/s11325-021-02401-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 01/14/2023]
Abstract
STUDY OBJECTIVES Obesity is often considered mandatory for the diagnosis of Metabolic Syndrome (MS). Data on the prevalence of MS in non-obese patients with Obstructive Sleep Apnea (OSA) is scarce. This study was aimed to determine the prevalence of MS in non-obese patients with OSA. METHODOLOGY All consecutively diagnosed patients with OSA between October 2018 and November 2019 were screened for metabolic syndrome. Patients with OSA and BMI < 25 kg/m2 (NOOSA) vs BMI > 25 kg/m2 (obese OSA) were compared. Lean waist NOOSA was defined as BMI < 25 kg/m2 and WC < 80 cm (32 in.) for women or < 90 cm (36 in.) for men. RESULTS During the study period, 502 patients were diagnosed with OSA. MS was observed in 35% of patients with NOOSA compared to obese patients with OSA (79%). In the NOOSA group, hypertension, impaired fasting glucose, diabetes mellitus and dyslipidemia were observed in 65, 48, 14 and 61% respectively and all of these parameters were significantly more common in the obese group (p < 0.001). Parameters of OSA severity (apnea-hypopnea index or AHI, time spent below 90% saturated or T90, and nadir oxygen) were significantly more severe in the obese group with OSA. Approximately 83% of patients in the NOOSA group had at least two metabolic risk factors, compared to the obese OSA group, in which 95% had two or more metabolic risk factors. Sixty-four percent of patients with NOOSA with lean waist had at least two metabolic risk factors. At BMI cut-offs of < 25, < 27 and < 30 kg/m2; 35, 46 and 57% of patients with OSA respectively had metabolic syndrome. CONCLUSION Metabolic syndrome was observed in approximately one in three patients with OSA and BMI < 25 kg/m2. Approximately two of every three lean waist non-obese patients with OSA had at least two markers of metabolic syndrome. The role of OSA in the development of metabolic syndrome in non-obese individuals needs further exploration.
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Affiliation(s)
| | - Abhishek Goyal
- Pulmonary Medicine, AIIMS, Saket Nagar, Bhopal, 462024, India.
| | | | - S K Goel
- Department of Biochemistry, AIIMS, Bhopal, India
| | - Ashok Kumar
- Department of Biochemistry, AIIMS, Bhopal, India
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Chaudhary P, Goyal A, Goel SK, Kumar A, Chaudhary S, Kirti Keshri S, Phadke Subhedar R. Women with OSA have higher chances of having metabolic syndrome than men: effect of gender on syndrome Z in cross sectional study. Sleep Med 2021; 79:83-87. [PMID: 33482457 DOI: 10.1016/j.sleep.2020.12.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 12/27/2020] [Accepted: 12/30/2020] [Indexed: 01/14/2023]
Abstract
STUDY OBJECTIVES This study was done to find out prevalence of Metabolic syndrome (MS) in patients with Obstructive Sleep Apnea (OSA) and whether there is any difference in prevalence of syndrome Z in male and female. METHODOLOGY All consecutive diagnosed patients with OSA between June 2015 and Oct 2019 were screened for metabolic syndrome and factors associated with metabolic syndrome in OSA were analyzed. RESULTS During study period, 502 patients (357 males; 145 females) were diagnosed with OSA. Mean age was 51.88 ± 12.18 years (females and males:55.91 ± 9.74 and 50.24 ± 12.70 years, respectively). Mean BMI was 31.60 ± 11.09 kg/m2 (female: 35.29 ± 7.19 and male: 30.1 ± 12.0 kg/m2) (p < 0.001). Mean AHI was 62.67 ± 35.22. Mild, moderate and severe category of OSA constituted 7.3%, 15.3% and 77.4% respectively. MS was found in 72.7% (365 out of 502) individuals with OSA. MS was found in 75.8%, 68.4 and 48.7% in severe, moderate and mild OSA patients respectively (p < 0.001). Females OSA patients had significantly high percentage (88.27%) of metabolic syndrome compared to males OSA patients (66.38%) {p < 0.001}. Female patients with SZ had higher metabolic score (p = 0.019) and were older (p < 0.001). CONCLUSION Metabolic syndrome is highly prevalent in OSA population (72.7%) and is much more common in female OSA patients (88%) than males OSA (68%). All OSA patients should be screened for MS so that early intervention can be done in these patients so as to prevent cardiovascular complications.
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Affiliation(s)
| | | | - S K Goel
- Biochemistry, AIIMS Bhopal, India
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Archontogeorgis K, Voulgaris A, Papanas N, Nena E, Xanthoudaki M, Pataka A, Schiza S, Rizzo M, Froudarakis ME, Steiropoulos P. Metabolic Syndrome in Patients with Coexistent Obstructive Sleep Apnea Syndrome and Chronic Obstructive Pulmonary Disease (Overlap Syndrome). Metab Syndr Relat Disord 2020; 18:296-301. [PMID: 32379990 DOI: 10.1089/met.2019.0126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: Evidence suggests that metabolic syndrome (MetS) is highly prevalent in patients with obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD). However, data on the prevalence of MetS in patients having both OSAS and COPD, or overlap syndrome (OS), are scarce. The aim of this study was to evaluate the prevalence and identify predictors of MetS in patients with OS. Methods: MetS was evaluated in consecutive patients who were diagnosed with OS by polysomnography and pulmonary function testing. Results: A total of 163 subjects (138 males and 25 females) were included. MetS was present in 38% of OS patients. Patients were divided into group A (OS without MetS group: 101 patients) and group B (OS with MetS group: 62 patients). Groups were similar in terms of pulmonary function and sleep parameters. In group B, abdominal obesity was the most prevalent component of MetS (100%), followed by hypertension (82.3%), hypertriglyceridemia (72.6%), and hyperglycemia (51.6%). Age (P = 0.009) and body mass index (P = 0.029) were independent predictors of MetS in patients with OS. Conclusions: An increased prevalence of MetS was observed in a group of patients with OS. Early identification and treatment of MetS may play a significant role in prevention of complications related to OS.
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Affiliation(s)
- Kostas Archontogeorgis
- MSc Program in Sleep Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Athanasios Voulgaris
- MSc Program in Sleep Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.,Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Papanas
- Second Department of Internal Medicine, and Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Evangelia Nena
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Maria Xanthoudaki
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Athanasia Pataka
- Respiratory Failure Unit, G. Papanikolaou General Hospital, Aristotle University, Thessaloniki, Greece
| | - Sophia Schiza
- Sleep Disorders Unit, Department of Respiratory Medicine, Medical School, University of Crete, Heraklion, Greece
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties School of Medicine, University of Palermo, Palermo, Italy.,Division of Endocrinology, Diabetes and Metabolism, University of South Carolina, School of Medicine Columbia, Columbia, South Carolina, USA
| | - Marios E Froudarakis
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Paschalis Steiropoulos
- MSc Program in Sleep Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.,Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Choi SJ, Lee SI, Joo EY. Habitual Alcohol Consumption and Metabolic Syndrome in Patients with Sleep Disordered Breathing. PLoS One 2016; 11:e0161276. [PMID: 27536782 PMCID: PMC4990257 DOI: 10.1371/journal.pone.0161276] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 08/02/2016] [Indexed: 11/23/2022] Open
Abstract
To investigate the associations between amount of habitual alcohol consumption (HAC) and prevalence of metabolic syndrome (MetS), sleep, and sleep-disordered breathing (SDB). We enrolled 683 untreated SDB male patients (age: 54.4 ± 7.80 y, apnea-hypopnea index (AHI): 29.0 ± 21.53/h). HAC was assessed as the average number of drinks consumed per week during the past 12 months. Anthropometric and biochemical markers were used to diagnose MetS. Clinical data and MetS components were compared according to the reported amounts of HAC (no drinking, light drinking <13, heavy drinking ≥13 drinks/week). As reported, 78.9% of the participants (n = 539) were regular drinkers; 33.7% (n = 230) were habitually heavy drinkers (mean: 30.7 drinks/week), and 45.2% (n = 309) were light drinkers (5.1 drinks/week). The overall prevalence of MetS was 36.9% (n = 252) and was most common in heavy drinkers (40.5%). Compared to non-drinkers and light drinkers, heavy drinkers had the greatest body mass index (BMI) and waist circumference. Central obesity, hypertension, and hyperglycemia were most prevalent in heavy drinkers. Sleep quality and severity of SDB were the worst in heavy drinkers. After adjusting for age, AHI, and BMI, heavy drinkers had a 1.71 times greater risk of MetS when compared with non-drinkers, and light and heavy drinkers had a 2.06 and 2.11 times higher risk of severe SDB than non-drinkers. HAC may increase the prevalence of MetS and deteriorate sleep in relation to amount of alcohol intake. Even light drinkers had more than twice higher risk of severe SDB than non-drinkers.
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Affiliation(s)
- Su Jung Choi
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Nursing, Samsung Medical Center, Department of Clinical Nursing Science, Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul, Korea
| | - Sung Ik Lee
- Department of Neurology, Inam NeuroScience Research Center, Sanbon Hospital, Wonkwang University School of Medicine, Gunpo-si, Korea
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
- * E-mail: ;
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Park MJ, Song I, Joo J, Kim TM, Yun HC, Yoo JH, Hong SN, Lee SH. The Relationship between Obstructive Sleep Apnea and Metabolic Syndrome in Adult. JOURNAL OF RHINOLOGY 2016. [DOI: 10.18787/jr.2016.23.2.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Min-Jeong Park
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Insik Song
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jaewoo Joo
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Tae Min Kim
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hee-Chul Yun
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Joon Hyuk Yoo
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seung-No Hong
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seung Hoon Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
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Wu WT, Tsai SS, Shih TS, Lin MH, Chou TC, Ting H, Wu TN, Liou SH. The Association between Obstructive Sleep Apnea and Metabolic Markers and Lipid Profiles. PLoS One 2015; 10:e0130279. [PMID: 26115005 PMCID: PMC4483259 DOI: 10.1371/journal.pone.0130279] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 05/18/2015] [Indexed: 12/18/2022] Open
Abstract
Purpose The purpose of this study was to investigate the association between apnea-hypopnea index (AHI) and metabolic markers and whether the elevated risk of Metabolic Syndrome (MetS) is related to Obstructive Sleep Apnea (OSA). Methods This cross-sectional study recruited 246 male bus drivers from one transportation company in Taiwan. Each participant was evaluated by a polysomnography (PSG) test and by blood lipids examination. Severity of OSA was categorized according to the apnea-hypopnea index (AHI). Results The results showed that a 73.3% prevalence of MetS in OSA (AHI > 15) and a 80.0% prevalence of MetS in severe OSA (AHI > 30) were found. After adjusting for confounding variables, an increased level of Body-Mass Index (BMI) and two non-MetS cardiovascular risk factors, total cholesterol/HDL-C ratio and TG/HDL-C ratio was significantly associated with AHI in subjects with severe OSA. MetS was about three times to be present in subjects with severe OSA, even adjusted for BMI. Conclusions The findings showed a high prevalence of MetS in OSA among professional drivers, especially in the severe group category. BMI was the major contributing factor to OSA. However, the present study did not find a sensitive clinical marker of a detrimental metabolic profile in OSA patients.
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Affiliation(s)
- Wei-Te Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Su-Shan Tsai
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Tung-Sheng Shih
- Institute of Labor, Occupational Safety And Health, Ministry of Labor, Taipei, Taiwan
| | - Ming-Hsiu Lin
- Institute of Labor, Occupational Safety And Health, Ministry of Labor, Taipei, Taiwan
| | - Tzu-Chieh Chou
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Hua Ting
- Department of Physical Medicine and Rehabilitation, Chung-Shan Medical University, Taichung, Taiwan
- Center of Sleep Medicine, Chung-Shan Medical University Hospital, Taichung, Taiwan
| | - Trong-Neng Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Department of Nursing, HungKuang University, Taichung, Taiwan
| | - Saou-Hsing Liou
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
- Department of Public Health, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
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Barreiro B, Garcia L, Lozano L, Almagro P, Quintana S, Alsina M, Heredia JL. Obstructive sleep apnea and metabolic syndrome in spanish population. Open Respir Med J 2013; 7:71-6. [PMID: 24222804 PMCID: PMC3822706 DOI: 10.2174/1874306401307010071] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 09/13/2013] [Accepted: 09/13/2013] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED Obstructive sleep apnea (OSA) is a clinical picture characterized by repeated episodes of obstruction of the upper airway. OSA is associated with cardiovascular risk factors, some of which are components of metabolic syndrome (MS). OBJECTIVES First, determine the prevalence of MS in patients with OSA visited in sleep clinic. Second, evaluate whether there is an independent association between MS components and the severity of OSA. METHODS Patients with clinical suspicion of OSA were evaluated by polysomnography. Three groups were defined according to apnea hypoapnea index (AHI): no OSA (AHI <5), mild-moderate (AHI≥ 5 ≤30), and severe (AHI> 30). All patients were determined in fasting blood glucose, total cholesterol, HDL cholesterol, triglycerides and insulin. MS was defined according to criteria of National Cholesterol Education Program (NCEP). RESULTS A total of 141 patients (mean age 54 ± 11 years) were evaluated. According to AIH, 25 subjects had no OSA and 116 had OSA (41mild-moderate and 75 severe). MS prevalence ranged from 43-81% in OSA group. Also, a significant increase in waist circumference, triglycerides, glucose, blood pressure levels, and a decrease in HDL cholesterol levels was observed in more severe OSA patients. All polysomnographic parameters correlated significantly with metabolic abnormalities. After a multiple regression analysis, abdominal obesity (p <0.02), glucose (p <0.01) and HDL cholesterol (p <0.001) were independently associated with OSA. CONCLUSIONS Our findings show high prevalence of MS in OSA, especially in severe group. A significant association between OSA and some of the components of MS was found in Spanish population.
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Affiliation(s)
- Bienvenido Barreiro
- Pneumology Department, Hospital Universitario Mutua Terrassa, University
of Barcelona
| | - Luis Garcia
- Endocrinology Department, Hospital Universitario Mutua Terrassa, University
of Barcelona
| | - Lourdes Lozano
- Pneumology Department, Hospital Universitario Mutua Terrassa, University
of Barcelona
| | - Pere Almagro
- Internal Medicine Department, Hospital Universitario Mutua Terrassa, University of Barcelona
| | - Salvador Quintana
- Pneumology Department, Hospital Universitario Mutua Terrassa, University
of Barcelona
| | | | - Jose Luis Heredia
- Pneumology Department, Hospital Universitario Mutua Terrassa, University
of Barcelona
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Comparison of metabolic syndrome with growing epidemic syndrome Z in terms of risk factors and gender differences. Sleep Breath 2012; 17:647-51. [DOI: 10.1007/s11325-012-0737-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 06/11/2012] [Accepted: 06/14/2012] [Indexed: 11/28/2022]
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Abstract
OSA is increasingly recognized as a major health problem in developed countries. Obesity is the most common risk factor in OSA and hence, the prevalence of OSA is undoubtedly rising given the epidemic of obesity. Recent data also suggest that OSA is highly associated with the metabolic syndrome, and it is postulated that OSA contributes to cardiometabolic dysfunction, and subsequently vasculopathy. Current evidence regarding the magnitude of impact on ultimate cardiovascular morbidity or mortality attributable to OSA-induced metabolic dysregulation is scarce. Given the known pathophysiological triggers of intermittent hypoxia and sleep fragmentation in OSA, the potential mechanisms of OSA-obesity-metabolic syndrome interaction involve sympathetic activation, oxidative stress, inflammation and neurohumoral changes. There is accumulating evidence from human and animal/cell models of intermittent hypoxia to map out these mechanistic pathways. In spite of support for an independent role of OSA in the contribution towards metabolic dysfunction, a healthy diet and appropriate lifestyle modifications towards better control of metabolic function are equally important as CPAP treatment in the holistic management of OSA.
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Affiliation(s)
- Jamie Chung Mei Lam
- Division of Respiratory Medicine, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong
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