title: Obstructive sleep apnoea syndrome and the metabolic syndrome in an internal medicine setting.
abstract: BACKGROUND
  Obstructive sleep apnoea syndrome (OSAS) is widely accepted as a cardiovascular risk factor. Lately it has been considered in turn as both a component and one of the causes of the metabolic syndrome (MS).
  
  
  METHODS
  We studied 281 heavy snorers of both sexes consecutively attending a metabolic clinic. Aim was to evaluate the association of OSAS and MS in a large series of patients within an internal medicine setting. Patients underwent a clinical and biochemical work up and performed unattended polysomnography.
  
  
  RESULTS
  Of 226 non-diabetic snorers, 48 had primary snoring; 54 mild, 51 moderate, and 73 severe OSAS. A positive association was found between OSAS severity, central obesity indices and the mean metabolic score (p=0.016). Prevalence of hypertension increased with OSA severity (p=0.010). Polysomnographic indices were correlated with the metabolic score, insulin levels and central obesity indices. At regression analysis, male sex (t=3.92; p=0.000) and waist circumference (t=3.93; p=0.000) were independently associated with AHI (apnoea/hypopnoea index), while ODI (oxygen desaturation index) and waist circumference were the independent predictors (t=2.16; p=0.033 and t=3.74; p=0.000 respectively) of the metabolic score. Prevalence of OSA was 83% in 55 patients with diabetes and 34% had severe OSA. Almost all diabetics with OSA had MS. The metabolic score was higher in diabetic OSA as compared to non-diabetic OSAS (p=0.000).
  
  
  CONCLUSIONS
  Our findings show a high prevalence of OSAS among patients referred to a metabolic outpatient clinic because of suspected metabolic disorders and heavy snoring and suggest a strong bidirectional association between OSAS and MS.
authors.affiliation: Department of Experimental Medicine, University La Sapienza, Rome, Italy. francesco.angelico@uniroma1.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Angelico
authors.forename: Maria
authors.initials: M
authors.lastname: del Ben
authors.forename: Teresa
authors.initials: T
authors.lastname: Augelletti
authors.forename: Rosanna
authors.initials: R
authors.lastname: de Vita
authors.forename: Rocco
authors.initials: R
authors.lastname: Roma
authors.forename: Francesco
authors.initials: F
authors.lastname: Violi
authors.forename: Mario
authors.initials: M
authors.lastname: Fabiani
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007333:Insulin Resistance; D007388:Internal Medicine / Q000706:statistics & numerical data*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D012913:Snoring / Q000175:diagnosis / Q000453:epidemiology*