Obstructive sleep apnea predicts risk of metabolic syndrome independently of obesity: a meta-analysis.
BACKGROUND
Obstructive sleep apnea (OSA) has been suggested to be associated with a high risk of metabolic syndrome (MS). However, results on whether the association between OSA and risk of MS is independent of obesity, and the effect of nocturnal intermittent hypoxia (IH) on MS, are conflicting. Our purpose was to estimate the magnitude of the independent association between OSA and risk of MS and further explore whether nocturnal IH in OSA plays a role in MS risk.


METHODS
The PubMed and EMBASE databases were systematically searched (until January 21, 2015) for available observational evidence. Unadjusted and body mass index (BMI)-adjusted pooled odds ratios (ORs) for MS in OSA or higher nocturnal IH were calculated using fixed or random models. Tests of homogeneity, publication bias, and robustness of the results were performed.


RESULTS
A total of 13 independent studies (involving 857 participants in 3 case-control studies and 7077 participants in 10 cross-sectional studies) were included. The OSA was significantly associated with an increased risk of MS in a meta-analysis of 10 studies (pooled OR = 1.72, 95% CI: 1.31-2.26,p< 0.001), with a BMI-adjusted pooled OR of 1.97 (95% CI: 1.34-2.88,p< 0.001). Pooled results from 3 studies on the oxygen desaturation index (ODI) and MS risk (OR = 1.96, 95% CI: 1.73-2.22,p< 0.001) and 3 studies on the cumulative percentage of sleep time with SpO2below 90% (CT90) and MS risk (OR = 1.05, 95% CI: 1.02-1.07,p< 0.001) were also significant.


CONCLUSIONS
Our findings demonstrated a significant association between OSA and increased MS risk independent of BMI, and further indicated a role of nocturnal IH in this association.
Department of Otolaryngology - Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Yingjun
Y
Qian
Department of Otolaryngology - Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Huajun
H
Xu
Department of Otolaryngology - Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Yuyu
Y
Wang
Department of Otolaryngology - Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Hongliang
H
Yi
Department of Otolaryngology - Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Jian
J
Guan
Department of Otolaryngology - Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Shankai
S
Yin
intermittent hypoxia; sleep-disordered breathing; syndrome X; systematic review
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