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. 2022 Mar 24:13:847324.
doi: 10.3389/fendo.2022.847324. eCollection 2022.

Association Between Abdominal Adipose Tissue Distribution and Obstructive Sleep Apnea in Chinese Obese Patients

Bingwei Ma  1   2 , Yingying Li  3 , Xingchun Wang  1   4   5 , Lei Du  1 , Shilin Wang  6 , Huihui Ma  1 , Donglei Zhou  2 , Taofeek Usman  5 , Liesheng Lu  1 , Shen Qu  1   4
Affiliations

Association Between Abdominal Adipose Tissue Distribution and Obstructive Sleep Apnea in Chinese Obese Patients

Bingwei Ma et al. Front Endocrinol (Lausanne). .

Abstract

Purpose: Factors related to the occurrence of obstructive sleep apnea syndrome (OSAS) in obesity have not been fully clarified. The aim of this study was to identify the association between OSAS and abdominal fat distribution in a cohort of Chinese obese patients.

Methods: This cross-sectional study collected demographic data of 122 obese patients who were admitted into the in-patient unit of the Department of Endocrinology, Shanghai Tenth People's Hospital from July 2018 to January 2021. OSAS was diagnosed based on the results of overnight polysomnography, and the abdominal fat distribution was measured by bioelectrical impedance analysis (BIA). Univariate and multivariate logistic regression analyses were used to investigate the association between OSAS and the distribution of abdominal fat.

Results: (1) The mean age (SD) of the obese patients included was 32.44 (11.81) years old, and the overall incidence rate of OSAS was 51.06%. Twenty-four (25.53%) patients had mild OSAS, 10 (10.64%) had moderate OSAS, and 14 (14.89%) had severe OSAS. The apnea hypopnea index (AHI) of men was significantly higher than that of women (5.50, interquartile range (IQR) 3.80-30.6 vs. 4.2, IQR 1.4-12 events/h, p = 0.014). Meanwhile, men had a significantly higher visceral fat area when compared with women (180.29 ± 51.64 vs. 143.88 ± 53.42 cm2, p = 0.002). (2) Patients with OSAS had a significantly higher waist circumference, fasting plasma glucose, 2 h postprandial plasma glucose, glycated hemoglobin, and visceral fat area than patients without OSAS (all p < 0.05). (3) AHI was significantly positively associated with BMI, neck circumference, waist circumference, and visceral fat area (r = 0.306, p = 0.003; r = 0.380, p < 0.001; r = 0.328, p = 0.002; r = 0.420, p < 0.001) but not with subcutaneous fat area (p = 0.094). Multivariate analysis demonstrated that abdominal fat area and fasting plasma glucose were independent risk factors for OSAS (odds ratio, 1.016; 95% confidence interval, 1.005-1,026, p = 0.005; odds ratio, 1.618; 95% confidence interval, 1.149-2.278, p = 0.006).

Conclusions: In obese patients, the abdominal visceral adipose deposit but not the subcutaneous fat area was associated with OSAS and was an independent risk factor for OSAS. Therefore, improving the distribution of abdominal fat may contribute to alleviating the severity of OSAS in obesity.

Keywords: BIA; OSAS; fat distribution; obesity; visceral adipose deposit.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Patient flow diagram showing patient selection. A total of 28 patients were excluded for technical reasons: 9 patients did not have an examination of the abdominal fat distribution, 6 patients without the assessment of OSAS, and 13 patients without neither the examination of abdominal fat distribution nor the assessment of OSAS.
Figure 2
Figure 2
The value of AHI in female and male patients (p = 0.014).
Figure 3
Figure 3
The visceral fat area in female and male patients (p = 0.002).
Figure 4
Figure 4
Comparison of neck circumference, waist circumference, hip circumference, visceral fat area (VFA), and subcutaneous fat area (SFA) between different severity OSAS. *p < 0.05; ***p < 0.001.
Figure 5
Figure 5
Comparison of abdominal fat distribution in obese patients with or without OSAS. *p < 0.05.
See this image and copyright information in PMC

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