Concurrent presence of inflammation and obstructive sleep apnea exacerbates the risk of metabolic syndrome

Abstract

Obstructive sleep apnea (OSA) leads to multiple end-organ morbidities that are mediated by the cumulative burden of oxidative stress and inflammation. Both OSA and inflammation play key roles in increased risk of cardiovascular disease (CVD). Thus, we hypothesized that the combination of inflammation and OSA could accelerate the development of metabolic syndrome (MetS) in a large cohort study.A total of 1835 participants were randomly selected from the ongoing Korean Genome and Epidemiology Study for the years between 2007 and 2015. Overnight polysomnography was performed on each participant. Blood was drawn for biochemical analyses. Participants with high or low inflammation were divided by high-sensitivity C-reactive protein (hsCRP). MetS was defined using the criteria of the modified National Cholesterol Education Program, Adult Treatment Panel III.The prevalence of MetS was higher among the subjects with OSA and high hsCRP levels than among the other corresponding groups. The incidence of MetS among the 4 groups stratified by OSA and inflammation status at the 6-year follow-up was 11.8%, 19.9%, 25.8%, and 36.0% (HsCRP[−]/OSA[−] vs HsCRP[+]/OSA[−] vs HsCRP[−]/OSA[+] vs HsCRP[+]/OSA[+], P < 0.01). After adjusting for age, sex, smoking, alcohol status, BMI, and change in BMI (ΔBMI) in a multiple logistic regression, the subjects with OSA and high hsCRP levels at follow-up had a 2.22-fold risk of developing MetS, as compared with those with no-OSA and low hsCRP levels (P < 0.01).MetS is more prevalent in the concurrent presence of inflammation and OSA. The combination of these conditions is associated with higher risk of MetS. Additional research is needed to help further define the significance of the combined effect of OSA and subclinical inflammation on the development of MetS in the context of reduction of CVD risk.

Association between obstructive sleep apnea and alcohol, caffeine and tobacco: A meta‐analysis

“…This meta‐analysis investigated the available evidence on the association between OSA and alcohol, caffeine and tobacco. Studies indicate associations between tobacco and OSA, and alcohol and OSA, however, conclusive evidence was not found until now. Based on the current available literature and on the eligibility criteria established for this systematic review, results indicate OSA is to be associated with the use of alcohol, but there is not enough scientific evidence to confirm the association between OSA and tobacco.…”

“…Studies that addressed consumed alcohol were positivity associated with OSA (OR = 1.33, 95%CI = 1.10‐1.62) (Figure ). Study that addresses the caffeine intake was not possible calculated the data.…”

“…Out of the included studies, the mean age for the samples ranged from 38.5 to 66 on OSA group, and 42.9 to 66 controls. Diagnostic methods we used for evaluating tobacco, alcohol and caffeine in the studies were questionnaire, and in other not report studies . Each study used specific AHI values for OSA definition through PSG.…”

“…It is worth noting that the question “was the follow‐up carried out over a sufficient time period?” was considered not applicable for the included studies, since none of them proposed longitudinal results. Of the 11 studies included had moderate risk of bias, and 2 as low risk of bias . Decisions regarding individual domains within the ‘Risk of bias’ tool were observed in Figure .…”

The risk of obstructive sleep apnea and its association with indices of general and abdominal obesity in a Nigerian family practice clinic: a cross-sectional study

“…Obstructive sleep apnea (OSA) is a common respiratory disease that is characterized by repetitive collapse of the upper airway leading to a marked reduction or complete cessation of airflow during sleep, causing oxygen desaturation and frequent arousals [1,2].…”