title: An investigation into the relationship between sleep-disordered breathing, the metabolic syndrome, cardiovascular risk profiles, and inflammation between South Asians and Caucasians residing in the United Kingdom.
abstract: BACKGROUND
  The aim of this study was to determine the prevalence of sleep-disordered breathing (SDB) in a South Asian and a Caucasian population and to compare the cardiovascular risk factors in those with SDB within these ethnic groups and determine if SDB is independently associated with the metabolic syndrome and markers of inflammation.
  
  
  METHODS
  A total of 1,598 participants within a U.K. multiethnic population underwent an oral glucose tolerance test, completed the Berlin Sleep Questionnaire, and provided anthropometric data and fasting bloods. Metabolic syndrome was classified according to National Cholesterol Education Program Adult Treatment Panel III criteria.
  
  
  RESULTS
  The prevalence of SDB was 28.3% and did not differ between the two ethnic groups. South Asians with SDB had a higher body fat percentage (38.4±10% vs. 35.6±9%, P=0.016), glycosylated hemoglobin (5.6±0.5% vs. 5.6±0.5%, P=0.001) and lower high-density lipoprotein cholesterol (1.21±0.23 mmol/L vs. 1.29±0.34 mmol/L, P=0.002) compared to Caucasians with SDB, who were older (59.6±8.6 years vs. 50.4±10.3 years, P<0.001) and had higher systolic blood pressure (139.8±18.5 mmHg vs. 131.7±18.6 mmHg, P<0.001). SDB was associated with metabolic syndrome after adjustment for age, gender, ethnicity, and waist circumference (odds ratio=1.54, 95% confidence interval 1.12-2.09, P=0.01). There was no independent association between SDB and markers of inflammation.
  
  
  CONCLUSIONS
  The relationship between SDB and metabolic syndrome is not driven via the inflammatory pathway. The prevalence of SDB is significantly higher in those with metabolic syndrome although these South Asians had a greater cardiovascular disease (CVD) risk profile the relationship is independent of ethnicity. Routine screening for SDB within primary/secondary care may have a role in the prevention of CVD and type 2 diabetes mellitus.
authors.affiliation: Department of Diabetes Research, University Hospitals of Leicester, NHS Trust, Leicester, United Kingdom. emer.brady@uhl-tr.nhs.uk
authors.forename: Emer M
authors.initials: EM
authors.lastname: Brady
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Davies
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Hall
authors.forename: Duncan C S
authors.initials: DC
authors.lastname: Talbot
authors.forename: Joanne L
authors.initials: JL
authors.lastname: Dick
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
mesh_terms: D000328:Adult; D000368:Aged; D001210:Asia, Southeastern / Q000208:ethnology; D044466:Asian People / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000453:epidemiology* / Q000208:ethnology; D006113:United Kingdom / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*