The prevalence of syndrome Z (the interaction of obstructive sleep apnoea with the metabolic syndrome) in a tertiary care center, Gujarat, India

Abstract

Background: The interaction of obstructive sleep apnoea (OSA) with vascular risk factors is known as syndrome Z which is also known as the metabolic syndrome or the insulin resistance syndrome and these include the hypertension, central obesity, insulin resistance and hyperlipidaemia. The objective of the present study was to investigate the prevalence and severity of syndrome Z at tertiary care center.Methods: This prospective study was conducted among 40 eligible patients between May and July 2018 at the tertiary care center included adult patients >18years of age. Overnight fasting glucose and lipid levels were measured, and baseline anthropometric data recorded. All sleep studies were scored and reported by a sleep physician. OSA was deemed to be present if the respiratory disturbance index (RDI) was >5, with mild, moderate and severe categories classified according to the Chicago criteria.Results: Mean age of participants was 52.7years, 77.5% were male, Mean BMI and waist circumference were 29.2kg/m2 and 113.8cm respectively. Almost 92.5% participants were known case of HTN, 85.0% were DM and 67.5% Dyslipidemia. Around 60.0% participants were belonged to severe grade of OSAS and 7 (17.5%) patients who fulfilled all five criteria for the diagnosis of the metabolic syndrome had severe OSAS. The prevalence of OSA in the entire group was 95.0%.Conclusions: The prevalence of syndrome Z in present study participants was very high. With the help of history and polysomnogram, metabolic syndrome should be screened for OSA. Early diagnosis and treatment of OSA is the essential part in the treatment of metabolic syndrome and hence CAD.

Evaluation of comorbid diseases in obstructive sleep apnea syndrome

“…The combination of obstructive sleep apnea and metabolic syndrome is referred to as "Syndrome Z" 15 . Although there is no clear consensus, changes in the hypothalamic-pituitary axis, recurrent hypoxia, inflammation, and generation of reactive oxygen species caused by adipokines are thought to be responsible for the changes seen at the cellular level in OSAS and metabolic syndrome 16 .…”