The association between obesity indices and obstructive sleep apnea is modified by age in a sex-specific manner

Saito²,

et al. 2021

JAMA Netw Open

IMPORTANCE The association between long sleep duration and mortality appears stronger in EastAsian populations than in North American or European populations.OBJECTIVES To assess the sex-specific association between sleep duration and all-cause and majorcause mortality in a pooled longitudinal cohort and to stratify the association by age and body mass index. DESIGN, SETTING, AND PARTICIPANTS This cohort study of individual-level data from 9 cohortsin the Asia Cohort Consortium was performed from January 1, 1984, to December 31, 2002. The final population included participants from Japan, China, Singapore, and Korea. Mean (SD) follow-up time was 14.0 (5.0) years for men and 13.4 (5.3) years for women. Data analysis was performed from

Section: Discussionmentioning

confidence: 90%

“…These results, in particular the absence of any modification by BMI on CVD mortality, are surprising given the association between BMI and obstructive sleep apnea. 32 …”

Section: Discussionmentioning

confidence: 99%

Association of Sleep Duration With All- and Major-Cause Mortality Among Adults in Japan, China, Singapore, and Korea

Saito²,

et al. 2021

JAMA Netw Open

“…However, in this cohort, NIV use was not frequent, even in those with advanced skeletal muscle involvement. Those who did require NIV were more likely to be older with a higher BMI or have COPD, factors that are related to OSA and NIV use in the general population 25 . This suggests that NIV requirement was of obstructive cause and unrelated to dysferlinopathy, although it is possible that mild diaphragmatic involvement is compounding hypopnoea in these patients and contributing to NIV requirement.…”

Section: Discussionmentioning

confidence: 99%

Cardiac and pulmonary findings in dysferlinopathy: A 3‐year, longitudinal study

et al. 2022

Introduction/Aims: There is debate about whether and to what extent either respiratory or cardiac dysfunction occurs in patients with dysferlinopathy. This study aimed to establish definitively whether dysfunction in either system is part of the dysferlinopathy phenotype. Methods: As part of the Jain Foundation's International Clinical Outcome Study (COS) for dysferlinopathy, objective measures of respiratory and cardiac function were collected twice, with a 3-y interval between tests, in 188 genetically confirmed patients aged 11-86 y (53% female). Measures included forced vital capacity (FVC), electrocardiogram (ECG), and echocardiogram (echo).Results: Mean FVC was 90% predicted at baseline, decreasing to 88% at year 3. FVC was less than 80% predicted in 44 patients (24%) at baseline and 48 patients (30%) by year 3, including ambulant participants. ECGs showed P-wave abnormalities indicative of delayed trans-atrial conduction in 58% of patients at baseline, representing a risk for developing atrial flutter or fibrillation. The prevalence of impaired left ventricular function or hypertrophy was comparable to that in the general population.Discussion: These results demonstrate clinically significant respiratory impairment and abnormal atrial conduction in some patients with dysferlinopathy. Therefore, we recommend that annual or biannual follow-up should include FVC measurement, enquiry about arrhythmia symptoms and peripheral pulse palpation to assess cardiac rhythm. However, periodic specialist cardiac review is probably not warranted unless prompted by symptoms or abnormal pulse findings.

“…Abdominal obesity (AO) is common in patients with OSA, and AO increases the risk of OSA. The results from two observational longitudinal studies confirmed a strong association between AO and OSA, whereas another study reported a stronger, more significant association in younger than in older individuals ( Nakagawa et al, 2011 ; Unal et al, 2019 ; Zhao et al, 2019 ; Balat et al, 2020 ; Liu et al, 2021 ; Qin et al, 2021 ). Moreover, the health risks of patients with AO differ from that of patients with non-AO.…”

Section: Introductionmentioning

confidence: 72%

Associations between abdominal obesity and the risk of stroke in Chinese older patients with obstructive sleep apnea: Is there an obesity paradox?

Yang

et al. 2022

Front. Aging Neurosci.

Background and purposeAbdominal obesity (AO) is a well-known independent risk factor for stroke in the general population although it remains unclear in the case of the elderly, especially in Chinese older patients with obstructive sleep apnea (OSA), considering the obesity paradox. This study aimed to investigate the association between AO and stroke among Chinese older patients with OSA.MethodsData were collected from January 2015 to October 2017, and 1,290 older patients (age 60–96 years) with OSA (apnea–hypopnea index ≥ 5 events/h on polysomnography) were consecutively enrolled from sleep centers at six hospitals, evaluated for AO defined as waist circumference (WC) using the standardized criteria for the Chinese population, and followed up prospectively for a median period of 42 months. Logistic regression and Cox regression analyses were used to determine the cross-sectional and longitudinal associations between AO and stroke risk in these participants and different groups of the severity of OSA.ResultsParticipants with AO had a higher prevalence of stroke at baseline. A higher incidence of stroke during a median follow-up period of 42 months in participants with AO than in participants without AO (12.4% vs. 6.8% and 8.3% vs. 2.4%, respectively; both P < 0.05) was predicted. Cross-sectional analysis revealed an association between AO and stroke (odds ratio [OR]1.96, 95% confidence interval [CI] 1.31–2.91), which was stronger among participants with moderate OSA only (OR 2.16, 95%CI 1.05–4.43). Cox regression analysis showed that, compared to participants without AO, participants with AO had a higher cumulative incidence of stroke (hazard ratio [HR] 2.16, 95% CI 1.12–4.04) during a median follow-up of 42 months, and this association was observed in patients with severe OSA only (HR 3.67, 95% CI 1.41–9.87) but not for individuals with mild OSA (HR = 1.84, 95% CI 0.43–6.23) and moderate OSA (HR = 1.98, 95% CI 0.73–6.45).ConclusionThe risk of stroke is associated with AO among Chinese older patients who have OSA, both at baseline and during follow-up, and the strength of the association varied by OSA severity. Active surveillance for early detection of AO could facilitate the implementation of stroke-preventive interventions in the Chinese older OSA population.