Association of Hypertriglyceridemic Waist Phenotype with Obstructive Sleep Apnea: A Cross-Sectional Study

Abstract

Objective Hypertriglyceridemic waist (HTGW) phenotype is an independent risk factor for metabolic disorders. Although obstructive sleep apnea (OSA) is associated with metabolic disorders, it is unclear whether there is an association between HTGW phenotype and OSA. Methods We enrolled consecutive participants presenting to a sleep center in Shanghai, China. Full-night polysomnography was performed, and serum triglyceride (TG) levels and waist circumference (WC) were calculated. HTGW phenotype was defined as increased WC (men > 90 cm, women > 80 cm) and elevated TG levels (> 1.7 mmol/L). Participants were classified into four groups: normal TG with normal WC (NTNW); normal TG with increased WC (NTGW); elevated TG with normal WC (HTNW); and elevated TG with enlarged WC, namely HTGW. The relationships between HTGW phenotypes and OSA were assessed using binary (apnea hypopnea index, [AHI]≥5/hr) and multinomial logistic regression analyses (clinical AHI severity categories). Results We included 3190 participants in this cross-sectional study. Compared to the NTNW phenotype, participants with NTGW and HTGW phenotypes had the significantly higher risk of OSA (AHI ≥5/hr, odds ratio [OR] = 2.51, 95% confidence interval [CI] = 1.91–3.31; OR = 3.76, 95% CI = 2.67–5.31, respectively), after adjustment for confounders. In subgroup analyses categorised by age, sex, and BMI, the aforementioned associations remained significant. The association between the NTGW, HTGW phenotype and OSA risk remained significant across the OSA severity groups. Multinomial logistic regression also revealed that the mild (OR = 1.63, 95% CI = 1.07–2.50), moderate (OR = 1.875, 95% CI = 1.22–2.88), and severe OSA (OR = 3.18, 95% CI = 2.14–4.73) were associated with HTGW phenotype. Conclusion Both NTGW and HTGW phenotype were positively associated with OSA risk in all subgroups. Further longitudinal follow-up studies are needed to determine the causal link and prognostic role of these metabolic factors.

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“…Wrzosek et al reported that significant correlations were found between the PSQI scores and serum triglycerides [ 36 ]. Compared with normal sleep time, insomnia in patients with sleep disorders was often accompanied by an increase in serum triglycerides [ 37 ]. Insomnia was related to most cases of cardiovascular and cerebrovascular diseases, some of which may be partially mediated by high triglycerides [ 38 ].…”

Association of Sleep Characteristics with Tinnitus and Hearing Loss

“…Possible answers for all three questions were never, rarely (1‐2 times per week), occasionally (3‐4 times per week), or frequently (≥5 times per week). Individuals who answered “occasionally” or “frequently” to all three questions were determined to be positive for “obstructive sleep apnea symptoms” in our analysis as in prior literature 26 . Data on OSA symptoms was available in a subset of the cohort (NHANES 2005‐2006, 2016‐2017, 2017‐2018, n = 4651).…”