A Higher Proportion of Metabolic Syndrome in Chinese Subjects with Sleep-Disordered Breathing: A Case-Control Study Based on Electrocardiogram-Derived Sleep Analysis

• Published in: PloS one Vol. 12; no. 1; p. e0169394
• Main Authors: Tseng, Ping-Huei, Lee, Pei-Lin, Hsu, Wei-Chung, Ma, Yan, Lee, Yi-Chia, Chiu, Han-Mo, Ho, Yi-Lwun, Chen, Ming-Fong, Wu, Ming-Shiang, Peng, Chung-Kang
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 12.01.2017; Public Library of Science (PLoS)
• Subjects: Abdomen; Adult; Aged; Apnea; Asian Continental Ancestry Group; Biochemistry; Biology and Life Sciences; Blood; Blood Glucose - metabolism; Blood Pressure; Body mass; Breathing; Cardiovascular disease; Case studies; Case-Control Studies; Cholesterol; Complications and side effects; Control methods; Critical care; EKG; Electrocardiography; Female; Hospitals; Humans; Hyperglycemia; Insulin resistance; Interdisciplinary aspects; Internal medicine; Laboratories; Male; Medicine; Medicine and Health Sciences; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - blood; Metabolic Syndrome - complications; Metabolic Syndrome - physiopathology; Metabolic syndrome X; Middle Aged; Obesity; Physical Sciences; Population studies; Prevalence; Prevalence studies (Epidemiology); Regression analysis; Respiration; Risk factors; Risk management; Sleep; Sleep apnea; Sleep Apnea Syndromes - blood; Sleep Apnea Syndromes - etiology; Sleep disorders; Studies; Taiwan; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0169394

The prevalence of metabolic syndrome (MS) has increased rapidly in Taiwan and worldwide. We aim to determine the association between sleep-disordered breathing (SDB) and MS in a Chinese general population. This case-control study recruited subjects who have undergone a prospective electrocardiogram-based cardiopulmonary coupling (CPC) sleep spectrogram as part of the periodic health check-ups at the National Taiwan University Hospital. Comprehensive anthropometrics, blood biochemistry, prevalence of MS and its individual components were compared with Bonferroni correction between 40 subjects with SDB, defined as the CPC-derived apnea-hypopnea index (CPC-AHI) >5 event/hour and 80 age- and sex-matched controls, defined as CPC-AHI <1 event/hour. MS was diagnosed based on the Adult Treatment Panel III, with a modification of waist circumference for Asians. Subjects with SDB were more obese with larger waist circumferences (95.1±12.9 vs. 87.3±6.9, P < .001) and borderline higher BMI (27.0±4.9 vs. 24.3±2.5, P = .002). Waist circumference was independently associated with the presence of SDB after adjustment for BMI, systolic blood pressure and fasting blood glucose in multiple regression analyses. Subjects with SDB had a higher prevalence of central obesity (72.5% vs. 42.5%, P = .002), hyperglycemia (45.0% vs. 26.3%, P = .04), MS (45.0% vs. 22.5%, P = .01) and number of MS components (2.4 ± 1.6 vs. 1.7 ± 1.4, P = .01) than the control group. Waist circumference was significantly correlated with both CPC-AHI (r = .492, P = .0013) and PSG-AHI (r = .699, P < .0001) in the SDB group. SDB was associated with a higher prevalence of MS and its individual components, notably central obesity, in a Chinese general population. Large-scale screening of high risk population with MS to identify subjects with SDB for appropriate management is warranted.