Nature and Science of Sleep (Dec 2021)

Association of Hypertriglyceridemic Waist Phenotype with Obstructive Sleep Apnea: A Cross-Sectional Study

  • Gu M,
  • Huang W,
  • Li X,
  • Liu Y,
  • Wang F,
  • Fang C,
  • Chen T

Journal volume & issue
Vol. Volume 13
pp. 2165 – 2173

Abstract

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Meizhen Gu,1,2,* Weijun Huang,2,3,* Xinyi Li,2,3 Yupu Liu,2,3 Fan Wang,2,3 Chao Fang,2,4 Ting Chen2,5 1Department of Otolaryngology-Head & Neck Surgery, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 2Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, People’s Republic of China; 3Department of Otolaryngology Head & Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China; 4Department of Otolaryngology-Head & Neck Surgery, The First Hospital of Putian, Putian, Fujian Province, People’s Republic of China; 5Department of Stomatology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chao Fang; Ting Chen Email [email protected]; [email protected]: 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.Keywords: obstructive sleep apnea, waist circumference, hypertriglyceridemia

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