Relationship between obstructive sleep apnea, insulin resistance, and metabolic syndrome: a nationwide population-based survey

• Published in: ENDOCRINE JOURNAL Vol. 70; no. 1; pp. 107 - 119
• Main Authors: Kim, Taeyun, Kang, Jihun
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 01-01-2023; Japan Science and Technology Agency
• Subjects: Adult; Apnea; Body mass index; Diabetes mellitus; Female; Humans; Insulin; Insulin Resistance; Korea National Health and Nutrition Examination Survey (KNHANES); Male; Metabolic syndrome; Metabolic Syndrome - complications; Nutrition Surveys; Obesity - complications; Obstructive sleep apnea; Post-menopause; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - epidemiology; Sleep disorders; STOP-Bang; Surveys; Insulin resistance; Metabolic syndrome; Obstructive sleep apnea; Korea National Health and Nutrition Examination Survey (KNHANES); STOP-Bang
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.EJ22-0280

We aimed to identify the association between obstructive sleep apnea (OSA), insulin resistance (IR), and metabolic syndrome (MetS) in a nationwide population-based sample. A total of 7,900 adults with information on the STOP-Bang score and MetS (3,341 men and 4,469 women) were identified from the dataset of the Korea National Health and Nutrition Examination Survey 2019–2020. The association between OSA, IR, MetS, and its components was estimated using complex sample logistic regression analysis with adjustments for age, body mass index, residence, smoking status, alcohol consumption, household income, education, and the presence of diabetes. Participants with a high OSA score were more likely to have IR (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.96–3.95 in men and OR 2.64, 95% CI 0.55–12.80 in women), MetS (OR 6.05, 95% CI 4.23–8.69 in men and OR 4.20, 95% CI 1.23–15.70 in women), and components of MetS, compared to individuals with a low OSA score. Compared to premenopausal women, postmenopausal women had a more intense association between OSA and IR (OR 1.78, 95% CI 0.13–24.43 for premenopausal women and OR 3.64, 95% CI 0.60–22.28 for postmenopausal women) and MetS (OR 2.58, 95% CI 0.23–29.55 for premenopausal women and OR 5.36, 95% CI 1.42–20.21 for postmenopausal women). OSA was associated with abdominal obesity and hypertension in premenopausal women, while all components of MetS were associated with OSA in postmenopausal women. Further studies are necessary to elucidate the underlying mechanisms of these findings.