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Zhang Y, Wang H, Yang J, Wang S, Tong W, Teng B. Obstructive Sleep Apnea Syndrome and Obesity Indicators, Circulating Blood Lipid Levels, and Adipokines Levels: A Bidirectional Two-Sample Mendelian Randomization Study. Nat Sci Sleep 2024; 16:573-583. [PMID: 38827393 PMCID: PMC11143989 DOI: 10.2147/nss.s460989] [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: 02/29/2024] [Accepted: 05/06/2024] [Indexed: 06/04/2024] Open
Abstract
Purpose This investigation sought to elucidate the genetic underpinnings that connect obesity indicators, circulating blood lipid levels, adipokines levels and obstructive sleep apnea syndrome (OSAS), employing a bidirectional two-sample Mendelian randomization (MR) analysis that utilizes data derived from extensive genome-wide association studies (GWAS). Methods We harnessed genetic datasets of OSAS available from the FinnGen consortium and summary data of four obesity indices (including neck circumference), seven blood lipid (including triglycerides) and eleven adipokines (including leptin) from the IEU OpenGWAS database. We primarily utilized inverse variance weighted (IVW), weighted median, and MR-Egger methods, alongside MR-PRESSO and Cochran's Q tests, to validate and assess the diversity and heterogeneity of our findings. Results After applying the Bonferroni correction, we identified significant correlations between OSAS and increased neck circumference (Odds Ratio [OR]: 3.472, 95% Confidence Interval [CI]: 1.954-6.169, P= 2.201E-05) and decreased high-density lipoprotein (HDL) cholesterol levels (OR: 0.904, 95% CI: 0.858-0.952, P= 1.251E-04). Concurrently, OSAS was linked to lower leptin levels (OR: 1.355, 95% CI: 1.069-1.718, P= 0.012) and leptin receptor levels (OR: 0.722, 95% CI: 0.530-0.996, P= 0.047). Sensitivity analyses revealed heterogeneity in HDL cholesterol and leptin indicators, but further multiplicative random effects IVW method analysis confirmed these correlations as significant (P< 0.05) without notable heterogeneity or horizontal pleiotropy in other instrumental variables. Conclusion This investigation compellingly supports the hypothesis that OSAS could be a genetic predisposition for elevated neck circumference, dyslipidemia, and adipokine imbalance. These findings unveil potential genetic interactions between OSAS and metabolic syndrome, providing new pathways for research in this domain. Future investigations should aim to delineate the specific biological pathways by which OSAS impacts metabolic syndrome. Understanding these mechanisms is critical for developing targeted prevention and therapeutic strategies.
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Affiliation(s)
- Yating Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
| | - Hongyan Wang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
| | - Jie Yang
- Department of Neurology, the First Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
| | - Sanchun Wang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
| | - Weifang Tong
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
| | - Bo Teng
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China
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Li J, Zhou K, Chen X. Changes of Serum Adiponectin Level in Patients with Obstructive Sleep Apnea Hypopnea Syndrome and Its Relationship with Sleep Monitoring Indexes. Can Respir J 2024; 2024:4071131. [PMID: 38524144 PMCID: PMC10959586 DOI: 10.1155/2024/4071131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/12/2024] [Indexed: 03/26/2024] Open
Abstract
Objective To observe the changes of serum adiponectin (AP) levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and explore the correlation between serum AP and polysomnography (PSG) parameters in patients with OSAHS. Methods The data of subjects who underwent PSG at the hospital between January 2021 and December 2022 were collected retrospectively and divided into simple snoring group (AHI < 5 times/h, n = 45), mild OSAHS group (5 ≤ AHI < 15 times/h, n = 63), moderate OSAHS group (15 ≤ AHI ≤ 30 times/h, n = 52), and severe OSAHS group (AHI > 30 times/h, n = 60). The general data, PSG indices, and serological indices of the subjects were collected and compared between groups. Pearson correlation analysis and partial correlation analysis were employed to examine the correlation between serum AP level and PSG parameters. Ordered logistic regression was employed to analyze the risk factors influencing the severity of OSAHS. The predictive capability of the serum AP level in determining the occurrence of OSAHS was assessed using ROC. The serum AP levels of subjects with different subtypes of PSG indicators were compared. Results In the simple snoring group, mild OSAHS group, moderate OSAHS group, and severe OSAHS group, there were statistically significant differences in microarousal count, MAI, AHI, times of blood oxygen decreased by ≥ 3%, L-SaO2, and TS90% among the 4 groups (P < 0.05). The level of serum AP was positively correlated with L-SaO2 and negatively correlated with the proportion of REM, microarousal count, MAI, AHI, times of blood oxygen decreased by ≥ 3%, TS90%, and LP (P < 0.05). High AHI was a risk factor affecting the severity of OSAHS (95% CI: 1.446-4.170). The AUC of serum AP level in diagnosing OSAHS was 0.906 (95% CI: 0.8601-0.9521), and when the Youden Index was 0.678, the sensitivity was 88.9%, and the specificity was 78.9% (P < 0.0001). In the population with a high microarousal count, high AHI, and high times of blood oxygen decreased by ≥ 3% and high TS90%, the serum AP level was lower than that in the low-level population (P < 0.05). In the population with high L-SaO2, the serum AP level was higher than that in low-level population (P < 0.05). Conclusion The level of serum AP decreased with the increase of the disease severity of patients with OSAHS and demonstrates a significant predictive capability for the occurrence of OSAHS. Monitoring the level of serum AP can effectively forecast the risk of OSAHS. Furthermore, alterations in serum AP levels are associated with both hypoxemia and a heightened frequency of arousal in patients with OSAHS.
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Affiliation(s)
- Ji Li
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Ningbo University, China
| | - Kejing Zhou
- Ningbo Yinzhou Second Hospital, Ningbo, China
| | - Xing Chen
- Ningbo Yinzhou Second Hospital, Ningbo, China
- Department of Ophthalmology, Yinzhou Second Hospital, Ningbo, China
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Fazlıoğlu N, Uysal P, Durmus S, Yurt S, Gelisgen R, Uzun H. Significance of Plasma Irisin, Adiponectin, and Retinol Binding Protein-4 Levels as Biomarkers for Obstructive Sleep Apnea Syndrome Severity. Biomolecules 2023; 13:1440. [PMID: 37892122 PMCID: PMC10604585 DOI: 10.3390/biom13101440] [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: 08/15/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder that is caused by the reduction or cessation of airflow in the upper airway. Irisin, retinol-binding protein-4 (RBP-4), and adiponectin are the three significant factors in the metabolic process of the human body. The objective of this study was to investigate whether plasma irisin, RBP-4, and adiponectin levels are associated with the severity of OSAS. METHODS According to inclusion and exclusion criteria, 125 patients with OSAS and 46 healthy, gender-matched controls were included in this study. The patients were classified according to the apnea hypopnea index (AHI) as 14 mild cases (5 < AHI < 15), 23 moderate OSAS cases (15 < AHI < 30), and 88 severe OSAS cases (AHI > 30). The plasma irisin, RBP-4, and adiponectin levels were measured and compared between groups. RESULTS RBP-4 levels were higher in severe OSAS compared to other groups, and irisin levels were significantly lower in severe OSAS compared to other groups. There was a negative correlation between irisin and RBP-4 (r = -0.421; p < 0.001), and irisin and AHI (r = -0.834; p < 0.001), and a positive correlation between irisin and adiponectin (r = 0.240; p = 0.002). There was a negative correlation between RBP-4 and adiponectin (r = -0.507; p < 0.001) and a positive correlation between RBP-4 and AHI (r = 0.473; p < 0.001). As a predictor of OSAS, adiponectin showed the highest specificity (84.8%) and RBP-4 the highest sensitivity (92.0%). CONCLUSION Circulating adiponectin, irisin, and RBP-4 may be new biomarkers in OSAS patients in addition to risk factors such as diabetes, obesity, and hypertension. When polysomnography is not available, these parameters and clinical data can be used to diagnose the disease. As a result, patients with an AHI score greater than thirty should be closely monitored for metabolic abnormalities.
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Affiliation(s)
- Nevin Fazlıoğlu
- Department of Pulmonary Medicine, Namık Kemal University, 59010 Tekirdag, Turkey;
| | - Pelin Uysal
- Maslak Hospital, Faculty of Medicine, Department of Pulmonary Medicine, Acibadem Mehmet Ali Aydinlar University, 34752 Istanbul, Turkey;
| | - Sinem Durmus
- Department of Biochemistry, School of Medicine, Istanbul University-Cerrahpasa, 34320 Istanbul, Turkey; (S.D.); (R.G.)
| | - Sibel Yurt
- Basaksehir Cam and Sakura State Hospital, Department of Pulmonary Medicine, University of Health Sciences, 34480 Istanbul, Turkey;
| | - Remise Gelisgen
- Department of Biochemistry, School of Medicine, Istanbul University-Cerrahpasa, 34320 Istanbul, Turkey; (S.D.); (R.G.)
| | - Hafize Uzun
- Department of Biochemistry, Faculty of Medicine, İstanbul Atlas University, 34403 Istanbul, Turkey
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Gobbi C, Morelhão PK, Branco BHM, Tufik S, Andersen ML. Does exercise improve the sleep quality of older overweight or obese adults? Psychogeriatrics 2022; 22:421-422. [PMID: 35272397 DOI: 10.1111/psyg.12820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/21/2022] [Accepted: 02/03/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | - Priscila K Morelhão
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
| | | | - Sergio Tufik
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
| | - Monica L Andersen
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil
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Sleep Disturbance and Metabolic Dysfunction: The Roles of Adipokines. Int J Mol Sci 2022; 23:ijms23031706. [PMID: 35163627 PMCID: PMC8835888 DOI: 10.3390/ijms23031706] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 12/14/2022] Open
Abstract
Adipokines are a growing group of peptide or protein hormones that play important roles in whole body metabolism and metabolic diseases. Sleep is an integral component of energy metabolism, and sleep disturbance has been implicated in a wide range of metabolic disorders. Accumulating evidence suggests that adipokines may play a role in mediating the close association between sleep disorders and systemic metabolic derangements. In this review, we briefly summarize a group of selected adipokines and their identified function in metabolism. Moreover, we provide a balanced overview of these adipokines and their roles in sleep physiology and sleep disorders from recent human and animal studies. These studies collectively demonstrate that the functions of adipokine in sleep physiology and disorders could be largely twofold: (1) adipokines have multifaceted roles in sleep physiology and sleep disorders, and (2) sleep disturbance can in turn affect adipokine functions that likely contribute to systemic metabolic derangements.
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Kim J, Pyo SS, Yoon DW. Obesity, Obstructive Sleep Apnea, and Metabolic Dysfunction. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2021. [DOI: 10.15324/kjcls.2021.53.4.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jinkwan Kim
- Department of Biomedical Laboratory Science, Jungwon University, Goesan, Korea
- Sleep Medicine Institute, Jungwon University, Goesan, Korea
| | - Sang Shin Pyo
- Department of Biomedical Laboratory Science, Jungwon University, Goesan, Korea
- Sleep Medicine Institute, Jungwon University, Goesan, Korea
| | - Dae Wui Yoon
- Department of Biomedical Laboratory Science, Jungwon University, Goesan, Korea
- Sleep Medicine Institute, Jungwon University, Goesan, Korea
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Evaluation of the relationship between polysomnography parameters, physical examination findings and oxidative stress parameters in patients with obstructive sleep apnea syndrome. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.929619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Association of C1q/TNF-Related Protein-9 (CTRP9) Level with Obstructive Sleep Apnea in Patients with Coronary Artery Disease. Mediators Inflamm 2020; 2020:7281391. [PMID: 32831639 PMCID: PMC7426787 DOI: 10.1155/2020/7281391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/01/2020] [Accepted: 07/20/2020] [Indexed: 12/26/2022] Open
Abstract
Background Obstructive sleep apnea (OSA) is closely related to the incidence and progression of coronary artery disease (CAD), and the mechanisms linking OSA and CAD are multifactorial. C1q/TNF-related protein-9 (CTRP9) is a novel adipokine that protects the heart against ischemic injury and ameliorates cardiac remodeling. We aimed to ascertain the clinical relevance of CTRP9 with OSA prevalence in patients with CAD. Methods From August 2016 to March 2019, consecutive eligible patients with CAD (n = 154; angina pectoris, n = 88; acute myocardial infarction [AMI], n = 66) underwent cardiorespiratory polygraphy. OSA was defined as an apnea-hypopnea index (AHI) ≥15 events·h-1. Plasma CTRP9 concentrations were measured by ELISA method. Results Moderate/severe OSA was present in 89 patients (57.8%). CTRP9 levels were significantly decreased in the moderate/severe OSA group than in the no/mild OSA group (4.7 [4.1-5.2] ng/mL vs. 4.9 [4.4-6.0] ng/mL, P = 0.003). The difference between groups was only observed in patients with AMI (3.0 [2.3-4.9] vs. 4.5 [3.2-7.9], P = 0.009). Correlation analysis showed that CTRP9 levels were negatively correlated with AHI (r = -0.238, P = 0.003) and oxygen desaturation index (r = -0.234, P = 0.004) and positively correlated with left ventricular ejection fraction (r = 0.251, P = 0.004) in all subjects. Multivariate analysis showed that male gender (OR 3.099, 95% CI 1.029-9.330, P = 0.044), BMI (OR 1.148, 95% CI 1.040-1.268, P = 0.006), and CTRP9 levels (OR 0.726, 95% CI 0.592-0.890, P = 0.002) were independently associated with the prevalence of moderate/severe OSA. Conclusions Plasma CTRP9 levels were independently related to the prevalence of moderate/severe OSA in patients with CAD, suggesting that CTRP9 might play a role in the pathogenesis of CAD exacerbated by OSA.
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Abstract
Obstructive sleep apnea (OSA), characterized by recurrent episodes of apnea during sleep and daytime sleepiness, seriously affects human health and may lead to systemic organ dysfunction. The pathogenesis of OSA is complex and still uncertain, but multiple surveys have shown that obesity is an important factor, and the incidence of OSA in people with obesity is as high as 30%. Adipokines are a group of proteins secreted from adipocytes, which are dysregulated in obesity and may contribute to OSA. Here, we review the most important and representative research results regarding the correlation between obesity-related adipokines including leptin, adiponectin, omentin-1, chemerin, and resistin and OSA in the past 5 years, provide an overview of these key adipokines, and analyze possible intrinsic mechanisms and influencing factors. The existing research shows that OSA is associated with an increase in the serum levels of leptin, chemerin, and resistin and a decrease in the levels of adiponectin and omentin-1; the findings presented here can be used to monitor the development of OSA and obesity, prevent future comorbidities, and identify risk factors for cardiovascular and other diseases, while different adipokines can be linked to OSA through different pathways such as insulin resistance, intermittent hypoxia, and inflammation, among others. We hope our review leads to a deeper and more comprehensive understanding of OSA based on the relevant literature, which will also provide directions for future clinical research.
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Affiliation(s)
- Xiongye Xu
- The First Clinical Medical College of Nanchang University, Nanchang, People's Republic of China
| | - Jixiong Xu
- The First Clinical Medical College of Nanchang University, Nanchang, People's Republic of China
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
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Song F, Zou J, Song Z, Xu H, Qian Y, Zhu H, Liu S, Guan J, Chen J, Yi H. Association of Adipocytokines With Carotid Intima Media Thickness and Arterial Stiffness in Obstructive Sleep Apnea Patients. Front Endocrinol (Lausanne) 2020; 11:177. [PMID: 32300333 PMCID: PMC7142226 DOI: 10.3389/fendo.2020.00177] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 03/12/2020] [Indexed: 12/19/2022] Open
Abstract
Objective: Obstructive sleep apnea (OSA) results in increased carotid intima-media thickness (IMT) and arterial stiffness; however, the association between adipocytokines and IMT/arterial stiffness in OSA patients is unclear. Methods: We enrolled 95 normal weight and overweight, not obese, participants from May 2018 to December 2018 in this study. All subjects underwent a carotid artery ultrasound examination and polysomnography. Blood samples were used to determine serum chemerin, adiponectin, SFRP5, and apelin levels. Correlations between two quantitative variables were assessed using the Pearson or Spearman coefficient. Stepwise models of multiple linear regression analysis were performed to assess the independent relationships. Result: IMT in OSA patients was significantly higher than in the non-snorers. There were significant differences in the arterial stiffness parameters such as distensibility coefficient (DC), compliance coefficient (CC), and pulse wave velocity (PWV). SFRP5 level was lower in OSA patients than in non-snorers. Adiponectin correlated with CC, DC, and PWV among OSA patients; however, the relationship disappeared after a multivariable adjustment. Age was independently associated with all quantitative IMT and stiffness indices. AHI and minimum oxygen saturation (Mini SaO2) were independently related to arterial stiffness. Conclusion: The quantitative IMT and carotid arterial elasticity were significantly worse among OSA patients. Age was the main independent factor correlated with quantitative IMT and arterial stiffness, and AHI and mini SaO2 were associated factors. There were no relationships between aforementioned adipocytokines and quantitative IMT/carotid arterial stiffness.
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Affiliation(s)
- Fan Song
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Juanjuan Zou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Zhiyuan Song
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Huajun Xu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Yinjun Qian
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Huaming Zhu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Suru Liu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Jian Guan
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Jie Chen
- Department of Ultrasound in Medicine, Shanghai Institute of Ultrasound in Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- *Correspondence: Jie Chen
| | - Hongliang Yi
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
- Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
- Hongliang Yi
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Interaction of Osteoarthritis and BMI on Leptin Promoter Methylation in Taiwanese Adults. Int J Mol Sci 2019; 21:ijms21010123. [PMID: 31878053 PMCID: PMC6981657 DOI: 10.3390/ijms21010123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/12/2019] [Accepted: 12/19/2019] [Indexed: 12/13/2022] Open
Abstract
Leptin (LEP) regulates glucose metabolism and energy storage in the body. Osteoarthritis (OA) is associated with the upregulation of serum LEP. LEP promoter methylation is associated with obesity. So far, few studies have explored the association of BMI and OA with LEP methylation. We assessed the interaction between body mass index (BMI) and OA on LEP promoter methylation. Data of 1114 participants comprising 583 men and 558 women, aged 30–70 years were retrieved from the Taiwan Biobank Database (2008–2015). Osteoarthritis was self-reported and cases were those who reported having ever been clinically diagnosed with osteoarthritis. BMI was categorized into underweight, normal weight, overweight, and obesity. The mean LEP promoter methylation level in individuals with osteoarthritis was 0.5509 ± 0.00437 and 0.5375 ± 0.00101 in those without osteoarthritis. The interaction between osteoarthritis and BMI on LEP promoter methylation was significant (p-value = 0.0180). With normal BMI as the reference, the mean LEP promoter methylation level was significantly higher in obese osteoarthritic individuals (β = 0.03696, p-value = 0.0187). However, there was no significant association between BMI and LEP promoter methylation in individuals without osteoarthritis, regardless of BMI. In conclusion, only obesity was significantly associated with LEP promoter methylation (higher levels) specifically in osteoarthritic patients.
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