title: Gender-specific anthropometric markers of adiposity, metabolic syndrome and visceral adiposity index (VAI) in patients with obstructive sleep apnea.
abstract: Obstructive sleep apnea often coexists with visceral adiposity and metabolic syndrome. In this study, we analysed gender-related differences in anthropometrics according to sleep apnea severity and metabolic abnormalities. In addition, the visceral adiposity index, a recently introduced marker of cardiometabolic risk, was analysed. Consecutive subjects with suspected obstructive sleep apnea (n = 528, 423 males, mean age ± standard deviation: 51.3 ± 12.8 years, body mass index: 31.0 ± 6.2 kg m(-2) ) were studied by full polysomnography (apnea-hypopnea index 43.4 ± 27.6 h(-1) ). Variables of general and visceral adiposity were measured (body mass index, neck, waist and hip circumferences, waist-to-hip ratio). The visceral adiposity index was calculated, and metabolic syndrome was assessed (NCEP-ATP III criteria). The sample included controls (apnea-hypopnea index <10 h(-1) , n = 55), and patients with mild-moderate (apnea-hypopnea index 10-30 h(-1) , n = 144) and severe sleep apnea (apnea-hypopnea index >30 h(-1) , n = 329). When anthropometric variables were entered in stepwise multiple regression, body mass index, waist circumference and diagnosis of metabolic syndrome were associated with the apnea-hypopnea index in men (adjusted R(2)  = 0.308); by contrast, only hip circumference and height-normalized neck circumference were associated with sleep apnea severity in women (adjusted R(2)  = 0.339). These results changed little in patients without metabolic syndrome; conversely, waist circumference was the only correlate of apnea-hypopnea index in men and women with metabolic syndrome. The visceral adiposity index increased with insulin resistance, but did not predict sleep apnea severity. These data suggest gender-related interactions between obstructive sleep apnea, obesity and metabolic abnormalities. The visceral adiposity index was a good marker of metabolic syndrome, but not of obstructive sleep apnea.
authors.affiliation: Biomedical Department of Internal and Specialistic Medicine (DIBIMIS), Section of Pneumology, University of Palermo, Palermo, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Mazzuca
authors.forename: Salvatore
authors.initials: S
authors.lastname: Battaglia
authors.forename: Oreste
authors.initials: O
authors.lastname: Marrone
authors.forename: Anna M
authors.initials: AM
authors.lastname: Marotta
authors.forename: Alessandra
authors.initials: A
authors.lastname: Castrogiovanni
authors.forename: Cristina
authors.initials: C
authors.lastname: Esquinas
authors.forename: Antonia
authors.initials: A
authors.lastname: Barcelò
authors.forename: Ferran
authors.initials: F
authors.lastname: Barbé
authors.forename: Maria R
authors.initials: MR
authors.lastname: Bonsignore
mesh_terms: D050154:Adiposity; D000328:Adult; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015992:Body Mass Index; D002319:Cardiovascular System / Q000378:metabolism; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000378:metabolism*; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis; D017286:Polysomnography; D012727:Sex Characteristics; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D055105:Waist Circumference; D049629:Waist-Hip Ratio
chemical_list: D015415:Biomarkers
keywords: fat distribution; receiving-operator characteristic curve; women