Effect of Intermittent Hypoxia on Metabolic Syndrome and Insulin Resistance in the General Male Population

Don't hold PAT: watch for and correct oximetry artifact

This study evaluated the accuracy of the algorithmic oxygen saturation (SpO2) nadir detection of WatchPAT (Zoll/Itamar, Caesarea, Israel) compared with visual inspection in a real-world setting. SpO2 tracings for 209 consecutive adult WatchPAT recordings were reviewed for SpO2 artifact, with erroneous SpO2 data removed manually. Error rates for SpO2 minima were determined across all studies, and relationships between correct and erroneous studies examined. The overall error rate for SpO2 nadir was 22.5%. Erroneous studies had overall less time spent at SpO2 ≤ 88%, higher true SpO2 nadir, lower mean body mass index, and greater artifact time; however, these variables were not associated with the magnitude of discrepancy between manual and algorithmically derived SpO2 minima. These data demonstrate that SpO2 nadir determined by WatchPAT algorithms should not be considered universally accurate. Like other home sleep apnea tests, visual inspection and manual correction of the study data are often required to derive accurate clinical results.

CITATION

Plante DT, Rumble ME. Don't hold PAT: watch for and correct oximetry artifact. J Clin Sleep Med. 2023;19(12):2113-2116.

Comorbid obstructive sleep apnea is associated with adverse cardiovascular outcomes in female patients with acute coronary syndrome complicating metabolic syndrome

BACKGROUND

Obstructive sleep apnea (OSA) and metabolic syndrome (MetS) are each increasingly common in patients with acute coronary syndrome (ACS). Whether OSA increases cardiovascular consequences in ACS patients with MetS has not been investigated.

HYPOTHESIS

OSA increases cardiovascular risk in ACS patients with MetS. We aimed to examine the association between OSA and cardiovascular consequences in ACS patients with MetS.

METHODS

In this prospective cohort study, we consecutive recruited 2160 ACS patients who underwent portable sleep breathing monitoring. OSA is defined as an apnea-hypopnea index (AHI) ≥ 15 events/h. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure.

RESULTS

A total of 1927 patients with ACS were enrolled. Among them, 1486 (77.1%) had MetS and 1014 (52.6%) had OSA. During 2.9 years of follow-up, the cumulative incidence of MACCE was similar between OSA and non-OSA groups in patients with MetS (21.9% vs. 17.9%, adjusted hazard ratio [HR] = 1.29 95% confidence interval [CI]: 0.99-1.67, p = .06) and patients without MetS (24.4% vs. 17.3%, adjusted HR = 1.21 95% CI: 0.73-2.03, p = .46). Patients with MetS and OSA had a significantly higher risk of MACCE than patients with MetS and without OSA in women (27.8% vs. 18.1%, adjusted HR = 1.70, 95% CI: 1.01-3.09, p = .04) but not in men (21.0% vs. 17.9%, adjusted HR = 1.19, 95% CI: 0.91-1.59, p = .21).

CONCLUSIONS

In hospitalized ACS patients with MetS, comorbid OSA was associated with increased risk of cardiovascular consequences among women.

Triglyceride-Glucose Index for the Diagnosis of Metabolic Syndrome: A Cross-Sectional Study of 298,652 Individuals Receiving a Health Check-Up in China

OBJECTIVE

We herein aim to explore the relationship between the triglyceride-glucose (TyG) index and metabolic syndrome (MS).

METHODS

We enrolled 298,652 individuals with an average age of 47.08 ± 12.94 years and who underwent health check-ups at the First Affiliated Hospital of Wuhu Wannan Medical College in this cross-sectional study from 2014 to 2016. We enlisted 125,025 women (41.86%) and 173,627 men (58.14%). The survey information included a questionnaire survey, a physical examination, and a laboratory examination.

RESULTS

The prevalence of MS increased gradually in the TyG-index subgroups (Q1, TyG <8.30; Q2, 8.30≤ TyG <8.83; and Q3, TyG ≥8.83). We noted significant differences in hypertension, hyperlipidemia, hyperglycemia, sex, age, body mass index (BMI), smoking and drinking habits, and estimated glomerular filtration rate between the TyG-index subgroups. Multiclass logistic regression analysis showed that the group with TyG <8.30 was the reference group, and the 8.30≤ TyG <8.83 and the TyG ≥8.83 groups exhibited a higher TyG index with MS, and a lower TyG index without MS disease. In the linear curve analysis of the TyG index and MS components, BMI, systolic blood pressure, and diastolic blood pressure showed upward trends, while high-density lipoprotein cholesterol showed no obvious trend in the TyG index at a range of 7.8-11.0. Receiver operating characteristic analysis was used to evaluate the predictive value of the TyG index, triglycerides, and fasting blood glucose for MS, and we found that the area under the TyG index curve was the largest (AUC = 0.89).

CONCLUSION

There were associations between the TyG index and MS and its components, and the TyG index is therefore of great value in the early diagnosis of MS.