Association of body fat composition and obstructive sleep apnea in the elderly: A longitudinal study

Martin, Magali Saint; Roche, Frédéric; Thomas, Thierry; Collet, Philippe; Barthélemy, Jean; Sforza, Émilia

doi:10.1002/oby.21121

Cited by 20 publications

(15 citation statements)

References 31 publications

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“…Previous studies showed the lack of an association between central fat mass effect and OSA in elderly patients. 28 This finding was confirmed by our results. Other studies using BIA demonstrated a relationship between the severity of neck fluid volume of water and the severity of SDB.…”

Section: Discussionsupporting

confidence: 90%

Heart failure and sleep‐disordered breathing: susceptibility to reduced muscle strength and preclinical congestion (SICA‐HF cohort)

et al. 2020

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Aims Increased sympathetic activation in patients with heart failure (HF) and sleep-disordered breathing (SDB) provokes cardiac decompensation and protein degradation and could lead to muscle wasting and muscle weakness. The aim of this study was to investigate the differences in body composition, muscle function, and the susceptibility of preclinical congestion among patients with HF and SDB compared with those without SDB. Methods and results We studied 111 outpatients with stable HF who were enrolled into the Studies Investigating Co-morbidities Aggravating Heart Failure. Echocardiography, short physical performance battery (SPPB), cardiopulmonary exercise testing, dual-energy X-ray absorptiometry, bioelectrical impedance analysis (BIA), tests of muscle strength, and polygraphy were performed. SDB was defined as apnoea/hypopnoea index (AHI) >5 per hour of sleep. Central sleep apnoea (CSA) and obstructive sleep apnoea (OSA) were defined as AHI >50% of central or obstructive origin, respectively. A total of 74 patients (66.7%) had any form of SDB [CSA (24 patients, 32.4%), OSA (47 patients, 63.5%)]. Patients with SDB showed increased muscle weakness (chair stand), reduced muscle strength, and lower values of SPPB score (P < 0.05). Patients with SDB did not show overt clinical signs of cardiac decompensation compared with those without SDB (P > 0.05) but had increased amounts of water (total body water, intracellular, and extracellular) measured using BIA (P < 0.05). Increased amounts of total body water were associated with the severity of SDB and inversely with muscle strength and exercise capacity measured by anaerobic threshold (P < 0.05). Altogether, 17 patients had muscle wasting. Of these, 11 (65%) patients had SDB (statistically not significant). Conclusions SDB is highly prevalent in patients with HF. Patients with SDB have lower muscle strength and tend to be more susceptible to preclinical congestion.

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Section: Discussionsupporting

confidence: 90%

Heart failure and sleep‐disordered breathing: susceptibility to reduced muscle strength and preclinical congestion (SICA‐HF cohort)

et al. 2020

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“…Fat mass, especially around the neck and abdomen, contribute to increased AHI and worsening hypoxemia. 25,26 The associations between reduced HGS in both dominant and non-dominant hands and worsening hypoxemia indices, being T90% and O2 nadir, with the addition of mean desaturation when whole body fat mass is not adjusted for, confirms previous finding showing those who spent more than 1% of the night with oxygen saturation below 90% had significantly weaker grip strength compared to those who did not. 13 Likewise, no association was detected between HGS and AHI, which is also in line with previous studies.…”

Section: Discussionsupporting

confidence: 77%

<p>Associations of OSA and Nocturnal Hypoxemia with Strength and Body Composition in Community Dwelling Middle Aged and Older Men</p>

Stevens

Appleton

Vincent

et al. 2020

NSS

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Purpose Reduced hand grip strength (HGS) is associated with poorer health in chronic conditions, yet there has been little research examining the association with hand grip strength and obstructive sleep apnea (OSA). Further, these studies have not examined, nor adjusted, for muscle mass. The aim of this study was to determine associations between OSA indices, HGS, muscle mass, and fat mass. Participants and Methods A total of 613 participants (age range 41–88, BMI 28.6 ± 4.3) from the population-based Men Androgen Inflammation Lifestyle Environment and Stress Study underwent in-home overnight polysomnography, assessment of dominant and non-dominant HGS, and dual x-ray absorptiometry to determine whole body muscle mass and fat mass. Linear models determined cross-sectional associations of polysomnographic-derived OSA indices with hand grip strength, muscle mass, and fat mass, whilst adjusting for lifestyle information (income, smoking status, diet, self-reported physical activity), blood sample derived testosterone and systemic inflammation (C-reactive protein), cardiometabolic health (cardiovascular disease, hypertension, type 2 diabetes), and depression. Results In adjusted models, reduced dominant HGS was associated with lower oxygen nadir (unstandardised β [B] = 0.19, 95% confidence interval [CI] 0.08 to 0.29), greater time spent below 90% oxygen saturation (B = −0.08, 95% CI −0.14 to −0.02), and increased apnea duration (B = −0.3, 95% CI −0.23 to −0.02). By contrast, there were no associations between HGS and both AHI and REM AHI. Fat mass was consistently associated with worsening OSA indices, whereas muscle mass demonstrated no associations with any OSA index. Conclusion Our findings suggest impairments in HGS may be related to fat infiltration of muscle, hypoxemia-induced reductions in peripheral neural innervation, or even endothelial dysfunction, which is a common outcome of hypoxemia. Longitudinal data are needed to further examine these hypotheses and establish if reduced grip strength in patients with OSA is associated with long-term adverse health outcomes.

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“…Therefore better characterization of body fat distribution rather than reliance upon the BMI and anthropometry is necessary to define obesity and its impact on OSA. Novel methods to characterize fat deposition such as dual energy X‐ray absorptiometry (DEXA) imaging have begun to be used …”

Section: Biomarkers Of Obstructive Sleep Apnoeamentioning

confidence: 99%

“…Novel methods to characterize fat deposition such as dual energy X-ray absorptiometry (DEXA) imaging have begun to be used. [18][19][20] New objective biomarkers are necessary for OSA. Future investigations should consider biomarkers of hypoxic stress or arousal, central ventilatory control and sleep homeostasis.…”

Section: Biomarkers Of Obstructive Sleep Apnoeamentioning

confidence: 99%

The genetics of obstructive sleep apnoea

2017

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Obstructive sleep apnoea (OSA) is a common chronic disease and is associated with high social and economic costs. OSA is heritable, and there is evidence of both direct genetic contributions to OSA susceptibility and indirect contributions via 'intermediate' phenotypes such as obesity, craniofacial structure, neurological control of upper airway muscles and of sleep and circadian rhythm. Investigation of the genetics of OSA is an important research area and may lead to improved understanding of disease aetiology, pathogenesis, adverse health consequences and new preventive strategies and treatments. Genetic studies of OSA have lagged behind other chronic diseases; however recent gene discovery efforts have been successful in finding genetic loci contributing to OSA-associated intermediate phenotypes. Nevertheless, many of the seminal questions relating to the genetic epidemiology of OSA and associated factors remain unanswered. This paper reviews the current state of knowledge of the genetics of OSA, with a focus on genomic approaches to understanding sleep apnoea.

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Association of body fat composition and obstructive sleep apnea in the elderly: A longitudinal study

Cited by 20 publications

References 31 publications

Heart failure and sleep‐disordered breathing: susceptibility to reduced muscle strength and preclinical congestion (SICA‐HF cohort)

Heart failure and sleep‐disordered breathing: susceptibility to reduced muscle strength and preclinical congestion (SICA‐HF cohort)

<p>Associations of OSA and Nocturnal Hypoxemia with Strength and Body Composition in Community Dwelling Middle Aged and Older Men</p>

The genetics of obstructive sleep apnoea

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