Relationship between obstructive sleep apnea, insulin resistance, and metabolic syndrome: a nationwide population-based survey

We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide population-based sample. A total of 7,900 adults with information on the STOP-Bang score and MetS (3,341 men and 4,469 women) were identified from the da...

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Published inENDOCRINE JOURNAL Vol. 70; no. 1; pp. 107 - 119
Main Authors Kim, Taeyun, Kang, Jihun
Format Journal Article
LanguageEnglish
Published Japan The Japan Endocrine Society 01.01.2023
Japan Science and Technology Agency
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Abstract We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide population-based sample. A total of 7,900 adults with information on the STOP-Bang score and MetS (3,341 men and 4,469 women) were identified from the dataset of the Korea National Health and Nutrition Examination Survey 2019–2020. The association between OSA, IR, MetS, and its components was estimated using complex sample logistic regression analysis with adjustments for age, body mass index, residence, smoking status, alcohol consumption, household income, education, and the presence of diabetes. Participants with a high OSA score were more likely to have IR (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.96–3.95 in men and OR 2.64, 95% CI 0.55–12.80 in women), MetS (OR 6.05, 95% CI 4.23–8.69 in men and OR 4.20, 95% CI 1.23–15.70 in women), and components of MetS, compared to individuals with a low OSA score. Compared to premenopausal women, postmenopausal women had a more intense association between OSA and IR (OR 1.78, 95% CI 0.13–24.43 for premenopausal women and OR 3.64, 95% CI 0.60–22.28 for postmenopausal women) and MetS (OR 2.58, 95% CI 0.23–29.55 for premenopausal women and OR 5.36, 95% CI 1.42–20.21 for postmenopausal women). OSA was associated with abdominal obesity and hypertension in premenopausal women, while all components of MetS were associated with OSA in postmenopausal women. Further studies are necessary to elucidate the underlying mechanisms of these findings.
AbstractList We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide population-based sample. A total of 7,900 adults with information on the STOP-Bang score and MetS (3,341 men and 4,469 women) were identified from the dataset of the Korea National Health and Nutrition Examination Survey 2019–2020. The association between OSA, IR, MetS, and its components was estimated using complex sample logistic regression analysis with adjustments for age, body mass index, residence, smoking status, alcohol consumption, household income, education, and the presence of diabetes. Participants with a high OSA score were more likely to have IR (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.96–3.95 in men and OR 2.64, 95% CI 0.55–12.80 in women), MetS (OR 6.05, 95% CI 4.23–8.69 in men and OR 4.20, 95% CI 1.23–15.70 in women), and components of MetS, compared to individuals with a low OSA score. Compared to premenopausal women, postmenopausal women had a more intense association between OSA and IR (OR 1.78, 95% CI 0.13–24.43 for premenopausal women and OR 3.64, 95% CI 0.60–22.28 for postmenopausal women) and MetS (OR 2.58, 95% CI 0.23–29.55 for premenopausal women and OR 5.36, 95% CI 1.42–20.21 for postmenopausal women). OSA was associated with abdominal obesity and hypertension in premenopausal women, while all components of MetS were associated with OSA in postmenopausal women. Further studies are necessary to elucidate the underlying mechanisms of these findings.
We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide population-based sample. A total of 7,900 adults with information on the STOP-Bang score and MetS (3,341 men and 4,469 women) were identified from the dataset of the Korea National Health and Nutrition Examination Survey 2019-2020. The association between OSA, IR, MetS, and its components was estimated using complex sample logistic regression analysis with adjustments for age, body mass index, residence, smoking status, alcohol consumption, household income, education, and the presence of diabetes. Participants with a high OSA score were more likely to have IR (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.96-3.95 in men and OR 2.64, 95% CI 0.55-12.80 in women), MetS (OR 6.05, 95% CI 4.23-8.69 in men and OR 4.20, 95% CI 1.23-15.70 in women), and components of MetS, compared to individuals with a low OSA score. Compared to premenopausal women, postmenopausal women had a more intense association between OSA and IR (OR 1.78, 95% CI 0.13-24.43 for premenopausal women and OR 3.64, 95% CI 0.60-22.28 for postmenopausal women) and MetS (OR 2.58, 95% CI 0.23-29.55 for premenopausal women and OR 5.36, 95% CI 1.42-20.21 for postmenopausal women). OSA was associated with abdominal obesity and hypertension in premenopausal women, while all components of MetS were associated with OSA in postmenopausal women. Further studies are necessary to elucidate the underlying mechanisms of these findings.We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide population-based sample. A total of 7,900 adults with information on the STOP-Bang score and MetS (3,341 men and 4,469 women) were identified from the dataset of the Korea National Health and Nutrition Examination Survey 2019-2020. The association between OSA, IR, MetS, and its components was estimated using complex sample logistic regression analysis with adjustments for age, body mass index, residence, smoking status, alcohol consumption, household income, education, and the presence of diabetes. Participants with a high OSA score were more likely to have IR (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.96-3.95 in men and OR 2.64, 95% CI 0.55-12.80 in women), MetS (OR 6.05, 95% CI 4.23-8.69 in men and OR 4.20, 95% CI 1.23-15.70 in women), and components of MetS, compared to individuals with a low OSA score. Compared to premenopausal women, postmenopausal women had a more intense association between OSA and IR (OR 1.78, 95% CI 0.13-24.43 for premenopausal women and OR 3.64, 95% CI 0.60-22.28 for postmenopausal women) and MetS (OR 2.58, 95% CI 0.23-29.55 for premenopausal women and OR 5.36, 95% CI 1.42-20.21 for postmenopausal women). OSA was associated with abdominal obesity and hypertension in premenopausal women, while all components of MetS were associated with OSA in postmenopausal women. Further studies are necessary to elucidate the underlying mechanisms of these findings.
[Abstract.] We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide population-based sample. A total of 7,900 adults with information on the STOP-Bang score and MetS (3,341 men and 4,469 women) were identified from the dataset of the Korea National Health and Nutrition Examination Survey 2019-2020. The association between OSA, IR, MetS, and its components was estimated using complex sample logistic regression analysis with adjustments for age, body mass index, residence, smoking status, alcohol consumption, household income, education, and the presence of diabetes. Participants with a high OSA score were more likely to have IR (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.96-3.95 in men and OR 2.64, 95% CI 0.55-12.80 in women), MetS (OR 6.05, 95% CI 4.23-8.69 in men and OR 4.20, 95% CI 1.23-15.70 in women), and components of MetS, compared to individuals with a low OSA score. Compared to premenopausal women, postmenopausal women had a more intense association between OSA and IR (OR 1.78, 95% CI 0.13-24.43 for premenopausal women and OR 3.64, 95% CI 0.60-22.28 for postmenopausal women) and MetS (OR 2.58, 95% CI 0.23-29.55 for premenopausal women and OR 5.36, 95% CI 1.42-20.21 for postmenopausal women). OSA was associated with abdominal obesity and hypertension in premenopausal women, while all components of MetS were associated with OSA in postmenopausal women. Further studies are necessary to elucidate the underlying mechanisms of these findings.
ArticleNumber EJ22-0280
Author Kang, Jihun
Kim, Taeyun
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  organization: Department of Family Medicine, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, Republic of Korea
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Cites_doi 10.1210/er.2012-1055
10.1161/CIRCULATIONAHA.105.556746
10.1378/chest.15-0903
10.1371/journal.pone.0143697
10.1164/rccm.200610-1527OC
10.1007/s13410-019-00768-5
10.1113/jphysiol.2003.048173
10.1001/jama.285.19.2486
10.1161/HYPERTENSIONAHA.116.08212
10.1016/j.sleep.2020.03.017
10.1016/j.pupt.2016.07.008
10.1016/j.smrv.2016.07.002
10.1016/j.sleep.2010.06.014
10.1164/rccm.200905-0671OC
10.1186/s12889-019-7361-5
10.2337/dc18-0675
10.1378/chest.06-1807
10.7570/jomes.2019.28.1.40
10.1161/01.STR.32.5.1104
10.3389/fphys.2021.792633
10.5664/jcsm.4608
10.1007/s11325-018-1748-x
10.3945/ajcn.2009.28449C
10.1161/01.ATV.0000048856.22331.50
10.1001/archoto.2010.1020
10.15585/mmwr.mm6702a1
10.1056/NEJM199312163292501
10.1007/s11695-019-03870-z
10.3346/jkms.2018.33.e197
10.1164/ajrccm.165.5.2103001
10.1007/s11325-019-01967-4
10.1007/s11325-021-02299-y
10.1111/j.1440-1843.2011.02081.x
10.1161/CIRCULATIONAHA.117.029400
10.5664/JCSM.1306
10.1093/ije/dyt228
10.5664/jcsm.26910
10.1111/j.1748-1716.2010.02237.x
10.1183/13993003.00918-2015
10.1164/rccm.200804-608OC
10.1513/AnnalsATS.202111-1260OC
10.1164/ajrccm.163.3.9911064
10.1016/j.trsl.2009.06.001
10.1007/s11695-007-9012-7
10.1186/s12890-015-0102-3
10.1097/ALN.0b013e31816d83e4
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Keywords Insulin resistance
Metabolic syndrome
Obstructive sleep apnea
Korea National Health and Nutrition Examination Survey (KNHANES)
STOP-Bang
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References 9 Chung F, Abdullah HR, Liao P (2016) STOP-Bang questionnaire: a practical approach to screen for obstructive sleep apnea. Chest 149: 631–638.
27 Ip MS, Lam B, Ng MM, Lam WK, Tsang KW, et al. (2002) Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 165: 670–676.
10 Chen L, Pivetta B, Nagappa M, Saripella A, Islam S, et al. (2021) Validation of the STOP-Bang questionnaire for screening of obstructive sleep apnea in the general population and commercial drivers: a systematic review and meta-analysis. Sleep Breath 25: 1741–1751.
21 Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, et al. (2019) 2018 Korean Society for the Study of Obesity Guideline for the Management of Obesity in Korea. J Obes Metab Syndr 28: 40–45.
46 Kumada M, Kihara S, Sumitsuji S, Kawamoto T, Matsumoto S, et al. (2003) Association of hypoadiponectinemia with coronary artery disease in men. Arterioscler Thromb Vasc Biol 23: 85–89.
40 Matthews KA, Kuller LH, Sutton-Tyrrell K, Chang YF (2001) Changes in cardiovascular risk factors during the perimenopause and postmenopause and carotid artery atherosclerosis in healthy women. Stroke 32: 1104–1111.
29 Iiyori N, Alonso LC, Li J, Sanders MH, Garcia-Ocana A, et al. (2007) Intermittent hypoxia causes insulin resistance in lean mice independent of autonomic activity. Am J Respir Crit Care Med 175: 851–857.
37 Theorell-Haglöw J, Berne C, Janson C, Lindberg E (2011) The role of obstructive sleep apnea in metabolic syndrome: a population-based study in women. Sleep Med 12: 329–334.
16 Nagappa M, Liao P, Wong J, Auckley D, Ramachandran SK, et al. (2015) Validation of the STOP-Bang questionnaire as a screening tool for obstructive sleep apnea among different populations: a systematic review and meta-analysis. PLoS One 10: e0143697.
34 Llanos OL, Galiatsatos P, Guzmán-Vélez E, Patil SP, Smith PL, et al. (2016) Pharyngeal collapsibility during sleep is elevated in insulin-resistant females with morbid obesity. Eur Respir J 47: 1718–1726.
39 Mauvais-Jarvis F, Clegg DJ, Hevener AL (2013) The role of estrogens in control of energy balance and glucose homeostasis. Endocr Rev 34: 309–338.
38 Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Rein J, et al. (2001) Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med 163: 608–613.
45 Ziemke F, Mantzoros CS (2010) Adiponectin in insulin resistance: lessons from translational research. Am J Clin Nutr 91: 258S–261S.
15 Bamanikar A, Duggal S, Sharma S, Rana S (2020) Assessment of risk for obstructive sleep apnea by using STOP-BANG questionnaire in type 2 diabetes mellitus. Int J Diabetes Dev Ctries 40: 173–177.
22 Jamal A, Phillips E, Gentzke AS, Homa DM, Babb SD, et al. (2018) Current cigarette smoking among adults—United States, 2016. MMWR Morb Mortal Wkly Rep 67: 53–59.
35 Lam JC, Mak JC, Ip MS (2012) Obesity, obstructive sleep apnoea and metabolic syndrome. Respirology 17: 223–236.
6 Vanek J, Prasko J, Genzor S, Ociskova M, Kantor K, et al. (2020) Obstructive sleep apnea, depression and cognitive impairment. Sleep Med 72: 50–58.
3 Labarca G, Gower J, Lamperti L, Dreyse J, Jorquera J (2020) Chronic intermittent hypoxia in obstructive sleep apnea: a narrative review from pathophysiological pathways to a precision clinical approach. Sleep Breath 24: 751–760.
33 Huang T, Lin BM, Stampfer MJ, Tworoger SS, Hu FB, et al. (2018) A population-based study of the bidirectional association between obstructive sleep apnea and type 2 diabetes in three prospective U.S. cohorts. Diabetes Care 41: 2111–2119.
2 Fritscher LG, Mottin CC, Canani S, Chatkin JM (2007) Obesity and obstructive sleep apnea-hypopnea syndrome: the impact of bariatric surgery. Obes Surg 17: 95–99.
17 Farney RJ, Walker BS, Farney RM, Snow GL, Walker JM (2011) The STOP-Bang equivalent model and prediction of severity of obstructive sleep apnea: relation to polysomnographic measurements of the apnea/hypopnea index. J Clin Sleep Med 7: 459–465B.
32 Xu S, Wan Y, Xu M, Ming J, Xing Y, et al. (2015) The association between obstructive sleep apnea and metabolic syndrome: a systematic review and meta-analysis. BMC Pulm Med 15: 105.
14 Shayestefar M, Sadeghniiat Haghighi K, Jahanfar S, Delvarianzadeh M, Nematzadeh F, et al. (2019) Assessment of the relationship between metabolic syndrome and obstructive sleep apnea in male drivers of Shahroud city in 2018: a cross sectional study. BMC Public Health 19: 1058.
30 Polotsky VY, Li J, Punjabi NM, Rubin AE, Smith PL, et al. (2003) Intermittent hypoxia increases insulin resistance in genetically obese mice. J Physiol 552: 253–264.
43 Ryan S, Taylor CT, McNicholas WT (2005) Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation 112: 2660–2667.
44 Lacedonia D, Nigro E, Matera MG, Scudiero O, Monaco ML, et al. (2016) Evaluation of adiponectin profile in Italian patients affected by obstructive sleep apnea syndrome. Pulm Pharmacol Ther 40: 104–108.
5 Murri M, Alcázar-Ramírez J, Garrido-Sánchez L, Linde F, Alcaide J, et al. (2009) Oxidative stress and metabolic changes after continuous positive airway pressure treatment according to previous metabolic disorders in sleep apnea-hypopnea syndrome patients. Transl Res 154: 111–121.
41 Pialoux V, Hanly PJ, Foster GE, Brugniaux JV, Beaudin AE, et al. (2009) Effects of exposure to intermittent hypoxia on oxidative stress and acute hypoxic ventilatory response in humans. Am J Respir Crit Care Med 180: 1002–1009.
28 Huang T, Sands SA, Stampfer MJ, Tworoger SS, Hu FB, et al. (2022) Insulin resistance, hyperglycemia, and risk of developing obstructive sleep apnea in U.S. men and women. Ann Am Thorac Soc doi: 10.1513/AnnalsATS.202111-1260OC. Online ahead of print.
7 Com G, Carroll JL, Tang X, Melguizo MS, Bower C, et al. (2015) Characteristics and surgical and clinical outcomes of severely obese children with obstructive sleep apnea. J Clin Sleep Med 11: 467–474.
4 Drager LF, McEvoy RD, Barbe F, Lorenzi-Filho G, Redline S (2017) Sleep apnea and cardiovascular disease: lessons from recent trials and need for team science. Circulation 136: 1840–1850.
26 Meyer MR, Clegg DJ, Prossnitz ER, Barton M (2011) Obesity, insulin resistance and diabetes: sex differences and role of oestrogen receptors. Acta Physiol (Oxf) 203: 259–269.
24 Kweon S, Kim Y, Jang Mj, Kim Y, Kim K, et al. (2014) Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 43: 69–77.
8 Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, et al. (2008) STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology 108: 812–821.
18 Jeon HJ, Bang YR, Yoon IY (2019) A validation study on three screening questionnaires for obstructive sleep apnea in a Korean community sample. Sleep Breath 23: 969–977.
13 Kono M, Tatsumi K, Saibara T, Nakamura A, Tanabe N, et al. (2007) Obstructive sleep apnea syndrome is associated with some components of metabolic syndrome. Chest 131: 1387–1392.
20 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 285: 2486–2497.
36 Zhao X, Xu H, Qian Y, Liu Y, Zou J, et al. (2019) Abdominal obesity is more strongly correlated with obstructive sleep apnea than general obesity in china: results from two separated observational and longitudinal studies. Obes Surg 29: 2535–2547.
11 Vasu TS, Doghramji K, Cavallazzi R, Grewal R, Hirani A, et al. (2010) Obstructive sleep apnea syndrome and postoperative complications: clinical use of the STOP-BANG questionnaire. Arch Otolaryngol Head Neck Surg 136: 1020–1024.
23 Gaziano JM, Buring JE, Breslow JL, Goldhaber SZ, Rosner B, et al. (1993) Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 329: 1829–1834.
19 Moon S, Park JH, Jang EJ, Park YK, Yu JM, et al. (2018) The cut-off values of surrogate measures for insulin sensitivity in a healthy population in Korea according to the Korean National Health and Nutrition Examination Survey (KNHANES) 2007–2010. J Korean Med Sci 33: e197.
12 Polotsky VY, Patil SP, Savransky V, Laffan A, Fonti S, et al. (2009) Obstructive sleep apnea, insulin resistance, and steatohepatitis in severe obesity. Am J Respir Crit Care Med 179: 228–234.
31 Parish JM, Adam T, Facchiano L (2007) Relationship of metabolic syndrome and obstructive sleep apnea. J Clin Sleep Med 3: 467–472.
25 Martins FO, Conde SV (2021) Gender differences in the context of obstructive sleep apnea and metabolic diseases. Front Physiol 12: 792633.
1 Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, et al. (2017) Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 34: 70–81.
42 Taylor KS, Murai H, Millar PJ, Haruki N, Kimmerly DS, et al. (2016) Arousal from sleep and sympathetic excitation during wakefulness. Hypertension 68: 1467–1474.
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References_xml – reference: 16 Nagappa M, Liao P, Wong J, Auckley D, Ramachandran SK, et al. (2015) Validation of the STOP-Bang questionnaire as a screening tool for obstructive sleep apnea among different populations: a systematic review and meta-analysis. PLoS One 10: e0143697.
– reference: 38 Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Rein J, et al. (2001) Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med 163: 608–613.
– reference: 40 Matthews KA, Kuller LH, Sutton-Tyrrell K, Chang YF (2001) Changes in cardiovascular risk factors during the perimenopause and postmenopause and carotid artery atherosclerosis in healthy women. Stroke 32: 1104–1111.
– reference: 32 Xu S, Wan Y, Xu M, Ming J, Xing Y, et al. (2015) The association between obstructive sleep apnea and metabolic syndrome: a systematic review and meta-analysis. BMC Pulm Med 15: 105.
– reference: 34 Llanos OL, Galiatsatos P, Guzmán-Vélez E, Patil SP, Smith PL, et al. (2016) Pharyngeal collapsibility during sleep is elevated in insulin-resistant females with morbid obesity. Eur Respir J 47: 1718–1726.
– reference: 5 Murri M, Alcázar-Ramírez J, Garrido-Sánchez L, Linde F, Alcaide J, et al. (2009) Oxidative stress and metabolic changes after continuous positive airway pressure treatment according to previous metabolic disorders in sleep apnea-hypopnea syndrome patients. Transl Res 154: 111–121.
– reference: 17 Farney RJ, Walker BS, Farney RM, Snow GL, Walker JM (2011) The STOP-Bang equivalent model and prediction of severity of obstructive sleep apnea: relation to polysomnographic measurements of the apnea/hypopnea index. J Clin Sleep Med 7: 459–465B.
– reference: 22 Jamal A, Phillips E, Gentzke AS, Homa DM, Babb SD, et al. (2018) Current cigarette smoking among adults—United States, 2016. MMWR Morb Mortal Wkly Rep 67: 53–59.
– reference: 46 Kumada M, Kihara S, Sumitsuji S, Kawamoto T, Matsumoto S, et al. (2003) Association of hypoadiponectinemia with coronary artery disease in men. Arterioscler Thromb Vasc Biol 23: 85–89.
– reference: 41 Pialoux V, Hanly PJ, Foster GE, Brugniaux JV, Beaudin AE, et al. (2009) Effects of exposure to intermittent hypoxia on oxidative stress and acute hypoxic ventilatory response in humans. Am J Respir Crit Care Med 180: 1002–1009.
– reference: 18 Jeon HJ, Bang YR, Yoon IY (2019) A validation study on three screening questionnaires for obstructive sleep apnea in a Korean community sample. Sleep Breath 23: 969–977.
– reference: 21 Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, et al. (2019) 2018 Korean Society for the Study of Obesity Guideline for the Management of Obesity in Korea. J Obes Metab Syndr 28: 40–45.
– reference: 13 Kono M, Tatsumi K, Saibara T, Nakamura A, Tanabe N, et al. (2007) Obstructive sleep apnea syndrome is associated with some components of metabolic syndrome. Chest 131: 1387–1392.
– reference: 20 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA 285: 2486–2497.
– reference: 11 Vasu TS, Doghramji K, Cavallazzi R, Grewal R, Hirani A, et al. (2010) Obstructive sleep apnea syndrome and postoperative complications: clinical use of the STOP-BANG questionnaire. Arch Otolaryngol Head Neck Surg 136: 1020–1024.
– reference: 37 Theorell-Haglöw J, Berne C, Janson C, Lindberg E (2011) The role of obstructive sleep apnea in metabolic syndrome: a population-based study in women. Sleep Med 12: 329–334.
– reference: 1 Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, et al. (2017) Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 34: 70–81.
– reference: 31 Parish JM, Adam T, Facchiano L (2007) Relationship of metabolic syndrome and obstructive sleep apnea. J Clin Sleep Med 3: 467–472.
– reference: 44 Lacedonia D, Nigro E, Matera MG, Scudiero O, Monaco ML, et al. (2016) Evaluation of adiponectin profile in Italian patients affected by obstructive sleep apnea syndrome. Pulm Pharmacol Ther 40: 104–108.
– reference: 8 Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, et al. (2008) STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology 108: 812–821.
– reference: 42 Taylor KS, Murai H, Millar PJ, Haruki N, Kimmerly DS, et al. (2016) Arousal from sleep and sympathetic excitation during wakefulness. Hypertension 68: 1467–1474.
– reference: 27 Ip MS, Lam B, Ng MM, Lam WK, Tsang KW, et al. (2002) Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 165: 670–676.
– reference: 2 Fritscher LG, Mottin CC, Canani S, Chatkin JM (2007) Obesity and obstructive sleep apnea-hypopnea syndrome: the impact of bariatric surgery. Obes Surg 17: 95–99.
– reference: 10 Chen L, Pivetta B, Nagappa M, Saripella A, Islam S, et al. (2021) Validation of the STOP-Bang questionnaire for screening of obstructive sleep apnea in the general population and commercial drivers: a systematic review and meta-analysis. Sleep Breath 25: 1741–1751.
– reference: 25 Martins FO, Conde SV (2021) Gender differences in the context of obstructive sleep apnea and metabolic diseases. Front Physiol 12: 792633.
– reference: 9 Chung F, Abdullah HR, Liao P (2016) STOP-Bang questionnaire: a practical approach to screen for obstructive sleep apnea. Chest 149: 631–638.
– reference: 28 Huang T, Sands SA, Stampfer MJ, Tworoger SS, Hu FB, et al. (2022) Insulin resistance, hyperglycemia, and risk of developing obstructive sleep apnea in U.S. men and women. Ann Am Thorac Soc doi: 10.1513/AnnalsATS.202111-1260OC. Online ahead of print.
– reference: 23 Gaziano JM, Buring JE, Breslow JL, Goldhaber SZ, Rosner B, et al. (1993) Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 329: 1829–1834.
– reference: 36 Zhao X, Xu H, Qian Y, Liu Y, Zou J, et al. (2019) Abdominal obesity is more strongly correlated with obstructive sleep apnea than general obesity in china: results from two separated observational and longitudinal studies. Obes Surg 29: 2535–2547.
– reference: 12 Polotsky VY, Patil SP, Savransky V, Laffan A, Fonti S, et al. (2009) Obstructive sleep apnea, insulin resistance, and steatohepatitis in severe obesity. Am J Respir Crit Care Med 179: 228–234.
– reference: 15 Bamanikar A, Duggal S, Sharma S, Rana S (2020) Assessment of risk for obstructive sleep apnea by using STOP-BANG questionnaire in type 2 diabetes mellitus. Int J Diabetes Dev Ctries 40: 173–177.
– reference: 3 Labarca G, Gower J, Lamperti L, Dreyse J, Jorquera J (2020) Chronic intermittent hypoxia in obstructive sleep apnea: a narrative review from pathophysiological pathways to a precision clinical approach. Sleep Breath 24: 751–760.
– reference: 6 Vanek J, Prasko J, Genzor S, Ociskova M, Kantor K, et al. (2020) Obstructive sleep apnea, depression and cognitive impairment. Sleep Med 72: 50–58.
– reference: 43 Ryan S, Taylor CT, McNicholas WT (2005) Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome. Circulation 112: 2660–2667.
– reference: 19 Moon S, Park JH, Jang EJ, Park YK, Yu JM, et al. (2018) The cut-off values of surrogate measures for insulin sensitivity in a healthy population in Korea according to the Korean National Health and Nutrition Examination Survey (KNHANES) 2007–2010. J Korean Med Sci 33: e197.
– reference: 29 Iiyori N, Alonso LC, Li J, Sanders MH, Garcia-Ocana A, et al. (2007) Intermittent hypoxia causes insulin resistance in lean mice independent of autonomic activity. Am J Respir Crit Care Med 175: 851–857.
– reference: 30 Polotsky VY, Li J, Punjabi NM, Rubin AE, Smith PL, et al. (2003) Intermittent hypoxia increases insulin resistance in genetically obese mice. J Physiol 552: 253–264.
– reference: 33 Huang T, Lin BM, Stampfer MJ, Tworoger SS, Hu FB, et al. (2018) A population-based study of the bidirectional association between obstructive sleep apnea and type 2 diabetes in three prospective U.S. cohorts. Diabetes Care 41: 2111–2119.
– reference: 24 Kweon S, Kim Y, Jang Mj, Kim Y, Kim K, et al. (2014) Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 43: 69–77.
– reference: 14 Shayestefar M, Sadeghniiat Haghighi K, Jahanfar S, Delvarianzadeh M, Nematzadeh F, et al. (2019) Assessment of the relationship between metabolic syndrome and obstructive sleep apnea in male drivers of Shahroud city in 2018: a cross sectional study. BMC Public Health 19: 1058.
– reference: 4 Drager LF, McEvoy RD, Barbe F, Lorenzi-Filho G, Redline S (2017) Sleep apnea and cardiovascular disease: lessons from recent trials and need for team science. Circulation 136: 1840–1850.
– reference: 45 Ziemke F, Mantzoros CS (2010) Adiponectin in insulin resistance: lessons from translational research. Am J Clin Nutr 91: 258S–261S.
– reference: 7 Com G, Carroll JL, Tang X, Melguizo MS, Bower C, et al. (2015) Characteristics and surgical and clinical outcomes of severely obese children with obstructive sleep apnea. J Clin Sleep Med 11: 467–474.
– reference: 26 Meyer MR, Clegg DJ, Prossnitz ER, Barton M (2011) Obesity, insulin resistance and diabetes: sex differences and role of oestrogen receptors. Acta Physiol (Oxf) 203: 259–269.
– reference: 35 Lam JC, Mak JC, Ip MS (2012) Obesity, obstructive sleep apnoea and metabolic syndrome. Respirology 17: 223–236.
– reference: 39 Mauvais-Jarvis F, Clegg DJ, Hevener AL (2013) The role of estrogens in control of energy balance and glucose homeostasis. Endocr Rev 34: 309–338.
– ident: 39
  doi: 10.1210/er.2012-1055
– ident: 43
  doi: 10.1161/CIRCULATIONAHA.105.556746
– ident: 9
  doi: 10.1378/chest.15-0903
– ident: 16
  doi: 10.1371/journal.pone.0143697
– ident: 29
  doi: 10.1164/rccm.200610-1527OC
– ident: 15
  doi: 10.1007/s13410-019-00768-5
– ident: 30
  doi: 10.1113/jphysiol.2003.048173
– ident: 20
  doi: 10.1001/jama.285.19.2486
– ident: 42
  doi: 10.1161/HYPERTENSIONAHA.116.08212
– ident: 6
  doi: 10.1016/j.sleep.2020.03.017
– ident: 44
  doi: 10.1016/j.pupt.2016.07.008
– ident: 1
  doi: 10.1016/j.smrv.2016.07.002
– ident: 37
  doi: 10.1016/j.sleep.2010.06.014
– ident: 41
  doi: 10.1164/rccm.200905-0671OC
– volume: 19
  start-page: 1058
  issn: 1471-2458
  year: 2019
  ident: 14
  publication-title: BMC Public Health
  doi: 10.1186/s12889-019-7361-5
– ident: 33
  doi: 10.2337/dc18-0675
– ident: 13
  doi: 10.1378/chest.06-1807
– ident: 21
  doi: 10.7570/jomes.2019.28.1.40
– ident: 40
  doi: 10.1161/01.STR.32.5.1104
– ident: 25
  doi: 10.3389/fphys.2021.792633
– ident: 7
  doi: 10.5664/jcsm.4608
– ident: 18
  doi: 10.1007/s11325-018-1748-x
– ident: 45
  doi: 10.3945/ajcn.2009.28449C
– ident: 46
  doi: 10.1161/01.ATV.0000048856.22331.50
– ident: 11
  doi: 10.1001/archoto.2010.1020
– ident: 22
  doi: 10.15585/mmwr.mm6702a1
– ident: 23
  doi: 10.1056/NEJM199312163292501
– ident: 36
  doi: 10.1007/s11695-019-03870-z
– ident: 19
  doi: 10.3346/jkms.2018.33.e197
– ident: 27
  doi: 10.1164/ajrccm.165.5.2103001
– ident: 3
  doi: 10.1007/s11325-019-01967-4
– ident: 10
  doi: 10.1007/s11325-021-02299-y
– ident: 35
  doi: 10.1111/j.1440-1843.2011.02081.x
– ident: 4
  doi: 10.1161/CIRCULATIONAHA.117.029400
– ident: 17
  doi: 10.5664/JCSM.1306
– ident: 24
  doi: 10.1093/ije/dyt228
– ident: 31
  doi: 10.5664/jcsm.26910
– ident: 26
  doi: 10.1111/j.1748-1716.2010.02237.x
– ident: 34
  doi: 10.1183/13993003.00918-2015
– ident: 12
  doi: 10.1164/rccm.200804-608OC
– ident: 28
  doi: 10.1513/AnnalsATS.202111-1260OC
– ident: 38
  doi: 10.1164/ajrccm.163.3.9911064
– ident: 5
  doi: 10.1016/j.trsl.2009.06.001
– ident: 2
  doi: 10.1007/s11695-007-9012-7
– ident: 32
  doi: 10.1186/s12890-015-0102-3
– ident: 8
  doi: 10.1097/ALN.0b013e31816d83e4
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Snippet We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide...
[Abstract.] We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide...
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SubjectTerms Adult
Apnea
Body mass index
Diabetes mellitus
Female
Humans
Insulin
Insulin Resistance
Korea National Health and Nutrition Examination Survey (KNHANES)
Male
Metabolic syndrome
Metabolic Syndrome - complications
Nutrition Surveys
Obesity - complications
Obstructive sleep apnea
Post-menopause
Sleep apnea
Sleep Apnea, Obstructive - complications
Sleep Apnea, Obstructive - diagnosis
Sleep Apnea, Obstructive - epidemiology
Sleep disorders
STOP-Bang
Surveys
Title Relationship between obstructive sleep apnea, insulin resistance, and metabolic syndrome: a nationwide population-based survey
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