Predicting Severe Sleep Apnea in Patients with Complaints: Pulse Oximetry and Body Mass Index

Kum, Rauf Oğuzhan; Kundi, Fatma Cemre Sazak; Baklacı, Deniz; Kum, Nurcan Yurtsever; Güler, İsmail; Yılmaz, Yavuz; Özcan, Müge

doi:10.5152/tao.2018.2928

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…Our analysis supports the role of the TyG index in diagnosing OSA and the diagnostic ability of this index is comparable to that of other anthropometric indices, such as waist-to-hip ratio, WC, and BMI [ 56 – 58 ], or other lipid indices like the visceral adiposity index (VAI), the lipid accumulation product (LAP), or atherogenic index of plasma (AIP) [ 59 ]. Notably, as a result of our analysis, the TyG index is significantly higher in patients with OSA with an SMD of 0.86 (95% CI: 0.58–1.13), confirming the relationship between components of metabolic syndrome (triglyceride and glucose) and OSA, which has also been suggested previously [ 60 , 61 ].…”

Section: Discussionsupporting

confidence: 77%

Triglyceride-glucose index and obstructive sleep apnea: a systematic review and meta-analysis

Behnoush,

Khalaji,

Ghondaghsaz

et al. 2024

Lipids Health Dis

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Background Obstructive sleep apnea (OSA) has a bidirectional association with metabolic syndrome, and insulin resistance (IR). The triglyceride-glucose (TyG) index could be a simply calculated marker of IR in OSA. However, its clinical application appears still limited. Hence, this systematic review and meta-analysis aimed to respond to this question by analyzing all the existing studies showing an association between OSA and the TyG index. Methods Four online databases, including PubMed, Scopus, the Web of Science, and Embase were searched for studies evaluating the TyG index in OSA. After screening and data extraction, a random-effect meta-analysis was performed to compare the TyG index in OSA patients vs. healthy controls by calculating standardized mean difference (SMD) and 95% confidence interval (CI) and pooling the area under the curves (AUCs) for diagnosis of OSA based on this index. Results Ten studies involving 16,726 individuals were included in the current systematic review. Meta-analysis indicated that there was a significantly higher TyG index in patients with OSA, compared with the healthy controls (SMD 0.856, 95% CI 0.579 to 1.132, P < 0.001). Also, TyG had a diagnostic ability for OSA representing a pooled AUC of 0.681 (95% CI 0.627 to 0.735). However, based on the two studies’ findings, no difference between different severities of OSA was observed. Finally, our data showed that the TyG index is a good potential predictor of adverse outcomes in these patients. Conclusion Our study revealed that the TyG index is an easy-to-measure marker of IR for assessing OSA, both in diagnosis and prognosis. Our study supports its implementation in routine practice to help clinicians in decision-making and patient stratification.

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Section: Discussionsupporting

confidence: 77%

Triglyceride-glucose index and obstructive sleep apnea: a systematic review and meta-analysis

Behnoush,

Khalaji,

Ghondaghsaz

et al. 2024

Lipids Health Dis

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“…Despite the fact that AUCs were almost similar for all three indices reported, LAP had a slightly higher AUC. Several studies investigated the diagnostic ability of anthropometric indices (e.g., waist-to-hip ratio (WHR), WC, and BMI) before [ 37 – 39 ]. Wang et al [ 37 ] compared WC, hip circumference (HC), and WHR for the diagnosis of moderate-to-severe OSA and severe OSA.…”

Section: Discussionmentioning

confidence: 99%

“…In another study, Lim et al [ 38 ] found WHR superior to BMI and WC in diagnosing OSA (AUC 0.701 for WHR). Kum et al [ 39 ] found that BMI ≥ 31.7 showed an AUC of 0.661 [95% CI 0.625 to 0.696], a specificity of 78.18%, and a sensitivity of 48.13% for diagnosing OSA. Although more studies are required, composite lipid indices showed better discrimination ability compared to traditional anthropometric indices.…”

Section: Discussionmentioning

confidence: 99%

Composite lipid indices in patients with obstructive sleep apnea: a systematic review and meta-analysis

et al. 2023

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Background One of the most prevalent sleep disorders affecting the individual’s daily life is obstructive sleep apnea (OSA), for which obesity is a major risk factor. Several novel lipid indices have been suggested to have associations with OSA, among which visceral adiposity index (VAI), atherogenic index of plasma (AIP), and lipid accumulation product (LAP) are the most important ones. Herein, the current study aimed to systematically investigate the association between these indices and OSA. Methods Four international databases, including PubMed, Scopus, the Web of Science, and Embase were searched in order to find relevant studies that investigated LAP, VAI, or AIP in OSA and compared them with non-OSA cases or within different severities of OSA. Random-effect meta-analysis was used to generate the standardized mean difference (SMD) and 95% confidence interval (CI) of the difference in lipid indices between OSA and non-OSA cases. Moreover, the pooled area under the receiver operating characteristic curves (AUCs) observed in individual studies for diagnosis of OSA based on these lipid indices were calculated by random-effect meta-analysis. Results Totally 14 original studies were included, comprised of 14,943 cases. AIP, LAP, and VAI were assessed in eight, five, and five studies, respectively. Overall, these lipid indices had acceptable diagnostic ability (AUC 0.70, 95% CI 0.67 to 073). Meta-analysis revealed that AIP was significantly higher in patients with OSA (SMD 0.71, 95% CI 0.45 to 0.97, P < 0.01). Moreover, AIP also increased in higher severities of OSA. Regarding LAP, a higher LAP was observed in OSA/patients with high risk for OSA rather than in controls/low risk for OSA (SMD 0.53, 95% CI 0.25 to 0.81, P < 0.01). VAI was also increased in OSA based on results from two studies. Conclusion These findings suggest that composite lipid indices are increased in OSA. Also, these indices can have the potential beneficiary diagnostic and prognostic ability in OSA. Future studies can confirm these findings and enlighten the role of lipid indices in OSA.

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“…Obesity is also an important predisposing factor for OSAHS, and AHI increases with weight gain. [57,58] Therefore, the question arises: are elevated endocan levels in individuals with OSAHS primarily caused by obesity? Accordingly, a subgroup analysis was performed based on whether the mean BMI exceeded 30 kg/m 2 and the results indicated that endocan levels remained higher in individuals with OSAHS than in controls, regardless of whether the mean BMI exceeded 30 kg/m 2 .…”

Section: Discussionmentioning

confidence: 99%

Association between elevated endocan levels and obstructive sleep apnea hypopnea syndrome in Turkey and China: A meta-analysis

He,

Li,

et al. 2023

Medicine

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Background: Endothelial dysfunction has been implicated in the pathogenesis of obstructive sleep apnea–hypopnea syndrome (OSAHS). Previous research has linked endothelial dysfunction to the vascular pathology marker endothelial cell-specific molecule-1 (endocan). This meta-analysis compared endocan concentrations among adult patients with OSAS and controls, and ascertained whether any differences exist. This study aimed to highlight the association between high endocan levels and OSAHS. Methods: A comprehensive, systematic literature search of the PubMed, Cochrane Library, China National Knowledge Infrastructure, Web of Science, Embase, and Wan Fang databases for relevant studies, published between January 2000 and June 10, 2013, was performed. Additionally, standardized mean differences, correlation coefficients, and adjusted odds ratios were used to assess the effect size. Statistical analyses were performed using R version 4.13 (Copenhagen: The Cochrane Collaboration) and Stata version 10.0 (StataCorp LLC, College Station, TX). Results: Twelve studies fulfilled the inclusion criteria. Nine studies reported endocan levels in patients with OSAHS and controls, and 6 reported serum endocan levels in relation to polysomnography (PSG) indexes (apnea-hypopnea index, body mass index, minimum oxygen (O2) saturation, and flow-mediated dilatation [FMD]). Five studies reported that serum endocan levels functioned independently as risk factors for OSAHS. These levels were determined to be elevated in adults with OSAHS compared with controls (standardized mean difference 1.30 [95% confidence interval (CI) 1.06–1.54]) and increased more significantly with increasing disease severity in individuals with OSAHS. Subjects were divided into different subgroups based on race, geographical region, sample type, and study design. Results indicated increased endocan levels across all OSAHS subgroups compared with the control group. The data highlighted a positive association between serum endocan levels and apnea-hypopnea index, and a negative association with FMD and minimum O2 saturation. The overall adjusted odds ratio between serum endocan levels and OSAHS was 1.04 (95% CI 1.02–1.06). Conclusion: Results of this meta-analysis provide further evidence supporting elevated endocan levels in adults with OSAHS. Serum endocan levels were correlated with various PSG indices and may be associated with OSAHS.

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Predicting Severe Sleep Apnea in Patients with Complaints: Pulse Oximetry and Body Mass Index

Cited by 5 publications

References 24 publications

Triglyceride-glucose index and obstructive sleep apnea: a systematic review and meta-analysis

Triglyceride-glucose index and obstructive sleep apnea: a systematic review and meta-analysis

Composite lipid indices in patients with obstructive sleep apnea: a systematic review and meta-analysis

Association between elevated endocan levels and obstructive sleep apnea hypopnea syndrome in Turkey and China: A meta-analysis

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