Prevalence of metabolic syndrome in a north Indian hospital-based population with obstructive sleep apnoea

Abstract

Background & objectives:Obstructive sleep apnoea (OSA) is known to be associated with cardiovascular risk factors and metabolic syndrome (MS). The burden of MS in patients with OSA in India is unknown. We investigated the prevalence of MS and its components in a cross-sectional study in patients with and without OSA in a hospital-based population of a tertiary health care centre in New Delhi, India.Methods:Consecutive patients undergoing overnight polysomnography in the Sleep Laboratory of the Department of Internal Medicine of All India Institute of Medical Sciences (AIIMS) hospital, New Delhi, were studied. Anthropometry and body composition analysis, blood pressure (BP), fasting blood glucose, insulin resistance by homeostasis model assessment (HOMA-IR) and fasting blood lipid profile were measured. MS was defined using the National Cholesterol Education Program Adult treatment panel III criteria, with Asian cut-off values for abdominal obesity.Results:Of the 272 subjects recruited, 187 (82%) had OSA [apnoea-hypopnoea index (AHI)>5 events/h] while 40 (18%) had a normal sleep study. Prevalence of MS in OSA patients was 79 per cent compared to 48 per cent in non-OSA individuals [OR 4.15, (2.05-8.56), P<0.001]. Prevalence of OSA in mild, moderate and severe OSA was 66, 72 and 86 per cent, respectively (P<0.001). Patients with OSA were more likely to have higher BP [OR: 1.06 (1.02-1.11)], fasting insulin [OR: 1.18 (1.05-1.32)], HOMA-IR [OR: 1.61 (1.11-2.33)] and waist circumference [OR: 1.20 (1.13-1.27)].Interpretation & conclusions:Our findings suggest that OSA is associated with a 4-fold higher occurrence of MS than patients without OSA. The prevalence of MS increases with increasing severity of OSA, therefore, early detection will be beneficial.

Relationship between metabolic syndrome & obstructive sleep apnoea in a hospital-based urban population

“…However, as Agrawal et al 16 fairly signaled, a causative relationship between OSA and MS cannot be established since obesity, a major risk factor for both conditions, that acts as a significant confounder, was not matched in both groups in the present study.…”

Prevalence and risk factors of moderate to severe obstructive sleep apnea syndrome in major depression: a observational and retrospective study on 703 subjects

“…Indeed, subjects with a metabolic syndrome have a higher risk of severe OSA [ 17 ], and individuals with moderate to severe OSA have a higher risk of metabolic syndrome [ 46 , 47 ]. In addition, the prevalence of metabolic syndrome increases with the severity of OSA [ 48 ]. However, in major depression, no studies have investigated the relationship between OSA and metabolic syndrome, which are two syndromes that frequently present in individuals with major depression [ 11 , 49 ].…”

The association between obstructive sleep apnea and metabolic syndrome: a systematic review and meta-analysis

“…AHI >5 events/h. ATP III 12 33 % 18 28 % No 1.30 (0.27–6.33) None 6 Nikolaos Papanas, 2010 [ 18 ] Hospital-based study, Greece PSG; AHI >5 events/h ATP III 53 71.7 % 30 36.7 % No 4.38 (1.69–11.35) None 6 Swastik Agrawal, 2011 [ 30 ] Hospital-based study, Northern India PSG; AHI >5 events/h. ATP III 187 79 % 40 48 % No 4.19 (2.05–8.56) None 6 H.-W.M.…”