title: Concurrent presence of inflammation and obstructive sleep apnea exacerbates the risk of metabolic syndrome: A KoGES 6-year follow-up study.
abstract: Obstructive sleep apnea (OSA) leads to multiple end-organ morbidities that are mediated by the cumulative burden of oxidative stress and inflammation. Both OSA and inflammation play key roles in increased risk of cardiovascular disease (CVD). Thus, we hypothesized that the combination of inflammation and OSA could accelerate the development of metabolic syndrome (MetS) in a large cohort study.A total of 1835 participants were randomly selected from the ongoing Korean Genome and Epidemiology Study for the years between 2007 and 2015. Overnight polysomnography was performed on each participant. Blood was drawn for biochemical analyses. Participants with high or low inflammation were divided by high-sensitivity C-reactive protein (hsCRP). MetS was defined using the criteria of the modified National Cholesterol Education Program, Adult Treatment Panel III.The prevalence of MetS was higher among the subjects with OSA and high hsCRP levels than among the other corresponding groups. The incidence of MetS among the 4 groups stratified by OSA and inflammation status at the 6-year follow-up was 11.8%, 19.9%, 25.8%, and 36.0% (HsCRP[-]/OSA[-] vs HsCRP[+]/OSA[-] vs HsCRP[-]/OSA[+] vs HsCRP[+]/OSA[+], P < 0.01). After adjusting for age, sex, smoking, alcohol status, BMI, and change in BMI (ΔBMI) in a multiple logistic regression, the subjects with OSA and high hsCRP levels at follow-up had a 2.22-fold risk of developing MetS, as compared with those with no-OSA and low hsCRP levels (P < 0.01).MetS is more prevalent in the concurrent presence of inflammation and OSA. The combination of these conditions is associated with higher risk of MetS. Additional research is needed to help further define the significance of the combined effect of OSA and subclinical inflammation on the development of MetS in the context of reduction of CVD risk.
authors.affiliation: Department of Biomedical Laboratory Science, College of Health Science, Jungwon University, Geo-San Institute of Human Genomic Study, Korea University Ansan Hospital, Korea University, Ansan Department of Health and Integrative Science, College of Health Science, Korea University, Seoul, Republic of Korea Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA Department of Pulmonary Sleep and Critical Care Medicine Disorder Center, College of Medicine, Korea University, Ansan, Republic of Korea.
authors.forename: Jinkwan
authors.initials: J
authors.lastname: Kim
authors.forename: Dae Wui
authors.initials: DW
authors.lastname: Yoon
authors.forename: Seung Ku
authors.initials: SK
authors.lastname: Lee
authors.forename: Seunggwan
authors.initials: S
authors.lastname: Lee
authors.forename: Kyung-Mee
authors.initials: KM
authors.lastname: Choi
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Robert
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000150:complications*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein