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Multicenter Study
. 2016 Oct:26:46-53.
doi: 10.1016/j.sleep.2015.06.003. Epub 2015 Jun 25.

Racial/ethnic differences in the associations between obesity measures and severity of sleep-disordered breathing: the Multi-Ethnic Study of Atherosclerosis

Xiaoli Chen  1 , Rui Wang  2 , Pamela L Lutsey  3 , Phyllis C Zee  4 , Sogol Javaheri  5 , Carmela Alcántara  6 , Chandra L Jackson  7 , Moyses Szklo  8 , Naresh Punjabi  9 , Susan Redline  5 , Michelle A Williams  10
Affiliations
Multicenter Study

Racial/ethnic differences in the associations between obesity measures and severity of sleep-disordered breathing: the Multi-Ethnic Study of Atherosclerosis

Xiaoli Chen et al. Sleep Med. 2016 Oct.

Abstract

Objectives: The objective of this study was to evaluate associations between obesity measures and sleep-disordered breathing severity among White, Black, Hispanic, and Chinese Americans.

Methods: The method used in this study was a community-based cross-sectional study of 2053 racially/ethnically diverse adults in the Multi-Ethnic Study of Atherosclerosis. Anthropometry and polysomnography were used to measure obesity and apnea-hypopnea index (AHI). Linear regression models were fitted to investigate associations of body mass index (BMI) and waist circumference with AHI (log transformed) with adjustment for sociodemographics, lifestyle factors, and comorbidities.

Results: The mean participant age was 68.4 (range: 54-93) years; 53.6% of participants were women. The median AHI was 9.1 events/h. There were significant associations of BMI and waist circumference with AHI in the overall cohort and within each racial/ethnic group. A significant interaction was observed between race/ethnicity and BMI (Pinteraction = 0.017). Models predicted that for each unit increase in BMI (kg/m2), the mean AHI increased by 19.7% for Chinese, 11.6% for Whites and Blacks, and 10.5% for Hispanics. Similarly, incremental changes in waist circumference were associated with larger increases in AHI among Chinese than among other groups.

Conclusions: Associations of BMI and waist circumference with AHI were stronger among Chinese than among other racial/ethnic groups. These findings highlight a potential emergence of elevated sleep-disordered breathing prevalence occurring in association with increasing obesity in Asian populations.

Keywords: Apnea–hypopnea index; Body mass index; Obesity; Polysomnography; Race/ethnicity; Sleep-disordered breathing; Waist circumference.

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Conflict of interest statement

All authors have no conflict of interest in relation to the work described.

Figures

Figure 1
Figure 1. Pairwise comparisons of the association between body mass index and log-transformed apnea-hypopnea index across racial/ethnic groups
Horizontal lines represent 95% confidence intervals for the difference in association between the two comparison groups (A–B for A vs. B). The following variables were adjusted for: age, sex (except for stratified analysis), income, education, hypertension, diabetes, smoking status, physical activity, and study site.
Figure 2
Figure 2. Pairwise comparisons of the association between waist circumference and log-transformed apnea-hypopnea index across racial/ethnic groups
Horizontal lines represent 95% confidence intervals for the difference in association between the two comparison groups (A–B for A vs. B). The following variables were adjusted for: age, sex (except for stratified analysis), income, education, hypertension, diabetes, smoking status, physical activity, and study site.
See this image and copyright information in PMC

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