Obstructive Sleep Apnea Risk Is Associated With Severity of Metabolic Syndrome: A Secondary Analysis of the 2015-2018 National Health and Nutrition Examination Survey.
Obstructive Sleep Apnea Risk Is Associated With Severity of Metabolic Syndrome: A Secondary Analysis of the 2015-2018 National Health and Nutrition Examination Survey.
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DOI：
10.1097/jcn.0000000000000868
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发表时间：
2022-09-01
影响因子：
2
通讯作者：
Imes, Christopher C.
中科院分区：
文献类型：
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作者：
Kariuki, Jacob K.;Yang, Kyeongra;Scott, Paul W.;Chasens, Eileen R.;Godzik, Cassandra;Luyster, Faith S.;Imes, Christopher C.
代谢综合征（MetS）和阻塞性睡眠呼吸暂停（OSA）与心脏代谢疾病的风险增加有关。OSA与MetS的共同发生是常见的，但关于OSA风险如何加剧MetS中存在的代谢障碍的数据有限。这项分析的目的是在2015-2018年国家健康和营养检查调查（NHANES）队列的代表性参与者样本中检查1）可改变的心脏代谢风险因素与OSA风险和MetS严重程度的关联;以及2）OSA风险和生活方式行为对MetS严重程度的影响。采用MetS Z评分评估MetS严重程度，采用多变量呼吸暂停预测（MAP）指数评估OSA风险。使用NHANES提供的样本权重进行数据分析。样本（N=11288）包括超重（平均体重指数29.6 ± 0.2 kg/m2）的成年人（> 20岁），按种族（36.9%非白人）和性别（51.9%女性）代表。总体而言，19.3%的样本具有升高的MetS严重程度（MetS Z评分≥ 1），38.4%处于OSA的高风险（MAP评分≥ 0.50）。高OSA风险与MetS严重程度升高相关（OR= 4.94; 95%置信区间[CI] 3.68-6.65）。OSA风险预测了MetS严重程度的增加（调整后：B=0.06，SE=0.02，p=0.013）。体力活动对MetS严重程度（OR= 0.52; CI：0.39-0.70）和OSA风险（OR= 0.59; CI 0.53-0.66）增加提供了最高保护。我们的研究结果表明，增加OSA风险加剧代谢综合征的严重程度，更大的体力活动可能会减轻风险。
Metabolic syndrome (MetS) and obstructive sleep apnea (OSA) are associated with increased risk of cardiometabolic disease. The co-occurrence of OSA with MetS is common but there is limited data on how OSA risk exacerbates the metabolic impairments present in MetS. The purpose of this analysis was to examine in a representative sample of participants in the National Health and Nutrition Examination Survey (NHANES) 2015–2018 cohorts 1) the association of modifiable cardiometabolic risk factors with OSA risk and MetS severity; and 2) the influence of OSA risk and lifestyle behaviors on MetS severity. MetS severity was assessed using MetS Z score while the risk of OSA was measured via multivariable apnea prediction (MAP) index. Data analyses were conducted using the sample weights provided by NHANES. The sample (N=11288) included adults (>20yrs) who were overweight (mean body mass index 29.6 ± 0.2 kg/m2), representative by race (36.9% Non-White) and gender (51.9% female). Overall, 19.3% of the sample had elevated MetS severity (MetS Z score ≥ 1), and 38.4% were at high risk of OSA (MAP score of ≥ 0.50). High OSA risk was associated with having elevated MetS severity (OR= 4.94; 95% confidence interval [CI] 3.68–6.65). OSA risk predicted increased MetS severity (Adjusted: B=0.06, SE=0.02, p=0.013). Physical activity provided the highest protection from increased MetS severity (OR= 0.52; CI: 0.39–0.70) and OSA risk (OR= 0.59; CI 0.53–0.66). Our findings suggest that increased OSA risk exacerbates MetS severity, and that greater physical activity may mitigate the risk.