Sleep apnoea and visceral adiposity in middle-aged male and female subjects

Abstract

In obese male subjects, visceral adiposity has been associated with obstructive sleep apnoea (OSA), while studies in overweight males and females are limited. Our goal was to examine the association between OSA and visceral fat in a relatively nonobese population and assess the effects of 2 months placebo-controlled continuous positive airway pressure (CPAP) use on abdominal fat.81 subjects, 22 middle-aged males and 20 post-menopausal females with OSA, and 19 male and 20 female controls were studied in the sleep laboratory for four nights. Abdominal (visceral (VAT) and subcutaneous (SAT) adipose tissue) and liver fat were assessed with computed tomography. OSA patients were re-assessed post-CPAP and post sham-CPAP.Apnoeic males had significantly higher VAT than controls, while apnoeic females had higher SAT than controls. In both sexes, OSA was associated with increased liver fat. In males, apnoea was associated with VAT whereas in females it was associated with subcutaneous, visceral and total fat. CPAP did not affect abdominal and liver fat.In overweight males, visceral adiposity is associated with OSA whereas in females it is associated with global adiposity. In overweight males, our therapeutic goal should be the reduction of visceral adiposity and its metabolic correlates, whereas, in females, weight loss may be sufficient. Shortterm CPAP treatment does not affect general, abdominal or intra-hepatic adiposity.

Anthropometric and physiologic assessment in sleep apnoea patients regarding body fat distribution

“…However, neck circumference appeared to be significantly correlated with AHI only in males, both in the correlation and regression model. It confirmed the observations of other researchers, according to whom neck circumference was the strongest predictor of OSA [2,4,5,8,11,14,17]. However, lack of significant correlation of the parameter with AHI in females raised doubts.…”

“…Neck circumference and BMI are the most significant determinants of AHI [7,8]. It was confirmed by the results of our research with reference to the whole material.…”

“…A lot of authors mentioned the importance of neck circumference as the parameter more strongly correlated with AHI than with BMI. According to them, neck circumference was responsible for approximately 30% of the range of AHI variability [2,4,5,8]. However, there was no data concerning the sex.…”

“…According to some authors, apnoea-hypopnoea index (AHI) shows a stronger correlation with BMI and abdominal circumference than neck circumference, which proves that abdominal obesity influences severity of OSA [18]. However, most researchers state that an increased neck circumference is, apart from BMI, the strongest parameter connected with OSA and with AHI value in particular, taking into account the fact that neck circumference correlates with the value of AHI parameter at 30% [2,4,5,8,11,17]. It is thought to be connected with a significantly higher accumulation of adipose tissue antero-laterally of the airways, notwithstanding general adiposity expressed with the BMI value [14].…”

Perfis metabólico e nutricional como preditores da síndrome da apneia obstrutiva do sono

“…Kritikou et al 34 , através de tomografia computadorizada, relataram que a adiposidade visceral é o principal fator associado à SAOS em homens, enquanto que a adiposidade geral é mais notada em mulheres. Os resultados deste estudo sugerem que a adiposidade abdominal e a total podem prever a gravidade da SAOS melhor do que a composição corporal pela bioimpedância elétrica.…”