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

Abstract

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.

Association between the triglyceride glucose index and obstructive sleep apnea and its symptoms: results from the NHANES

“…Hence, although other indices demonstrate strong predictive abilities for OSA, the TyG index retains unique advantages. A recent meta-analysis aligns with this viewpoint, thus suggesting that the diagnostic accuracy of the TyG index is similar to that of other anthropometric indices [ 23 ].…”

“…A recent meta-analysis indicated that the TyG index serves as a readily measurable indicator of insulin resistance and is employed in the assessment of OSA for both diagnostic and prognostic purposes. Patients with OSA exhibit significantly greater TyG index levels than healthy controls [ 23 ]. The TyG index may be an independent risk factor for OSA [ 24 ].…”

Relationship between obstructive sleep apnoea syndrome and gastrointestinal diseases: a systematic review and Meta-analysis

“…The prevalence of obesity in patients with OSA is also an important factor exacerbating the risk of GID. Obesity may exacerbate the symptoms of GID by increasing the intra-abdominal pressure and causing metabolic disturbances 27 . In addition, obesity may also affect the rate of gastric emptying and the balance of intestinal flora, which may further exacerbate gastrointestinal problems 28 .…”

Association between obstructive sleep apnea and visceral adiposity index and lipid accumulation product: NHANES 2015–2018

“…In addition, daytime fatigue and reduced energy levels can decrease motivation for physical activity, further promoting weight gain [ 30 ]. Moreover, evidence suggests that OSA itself can change the lipid profile [ 31 ]; OSA itself exacerbates lipid abnormalities by increasing insulin resistance and inflammatory responses, creating a negative feedback loop [ 32 , 33 ]. The elevation in blood lipids puts pressure on the cardiovascular system, elevating the workload of the heart and blood vessels, which is unfavorable for patients with OSA, as they are already under the cardiovascular burden caused by intermittent hypoxia.…”