Body Fat Indices as Effective Predictors of Insulin Resistance in Obstructive Sleep Apnea: Evidence from a Cross-Sectional and Longitudinal Study

BFI as Predictors of IR in OSA



Body fat indices serve as predictive markers of insulin resistance (IR) in metabolic diseases. IR is common in obstructive sleep apnea (OSA). However, whether body fat indices have utility as predictors of IR in OSA remain unknown.

Materials and Methods

A longitudinal study was conducted in 46 patients undergoing bariatric surgery to explore the relationship between IR and body fat indices. Then, a cross-sectional study was performed to evaluate the relationships between body fat indices and IR, and receiver operating characteristic (ROC) curves were generated. Body indices, homeostasis model assessment index of insulin resistance (HOMA-IR), biological indicators, and polysomnographic variables were collected.


In the longitudinal study, significant relationships were found between remission of IR and changes in visceral adiposity index (VAI) (r = 0.452, P < 0.05) and triglyceride-glucose index (TyG) (r = 0.650, P < 0.01). In the cross-sectional study, lipid accumulation product (LAP) (best cutoff value: 30.16, area under the curve (AUC) = 0.728, P < 0.001) and TyG (best cutoff value: 8.54, AUC = 0.740, P < 0.001) were indicators of IR in normal weight group. In overweight/obese group, body mass index (BMI) (best cutoff value: 27.69 AUC = 0.707, P < 0.001) and waist circumference (WC) (best cutoff value: 97.25, AUC = 0.708, P < 0.001) were markers of IR. TyG showed better ability to predict IR in normal weight females (best cutoff value: 8.39 AUC = 0.813, P < 0.001).


Body fat indices are predictive markers of IR in patients with OSA.

Graphical abstract

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Fig. 1

Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.



obstructive sleep apnea




body mass index


neck circumference


waist circumference


hip circumference


waist-hip rate


waist height rate


total cholesterol




high-density lipoprotein cholesterol


low-density lipoprotein cholesterol


lipid accumulation product


visceral adiposity index


triglycerides and glucose index


homeostasis model assessment index of insulin resistance


apnea-hypopnea index


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The authors acknowledge the help of all staff in establishing this sleep cohort study.


This study was supported by grants-in-aid from Shanghai Municipal Commission of Science and Technology (Grant No.18DZ2260200); Innovative research team of high-level local universities in Shanghai; National Natural Science Foundation of China (81970870; 82071030); Innovation Program of Shanghai Municipal Education Commission (2017-01-07-00-02-E00047); multi-center clinical research project from School of Medicine, Shanghai Jiao Tong University (DLY201502).

Author information




The authors take responsibility and vouch for the accuracy and completeness of the data and analyses. Prof. S.Y., J.G., and H.Y. had full access to all of the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. Study design: R.W., J.G., and S.Y.; data collection: R.W., Z.G., H.X., J.Z., X.L., and Y.L.; statistical analysis: R.W., Z.G.; manuscript draft: R.W., Z.G., H.X., H.Y., and S.Y. All authors have seen and approved the manuscript.

Corresponding authors

Correspondence to Huajun Xu or Cuiping Jiang or Jian Guan.

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Ethical Approval

This study was approved by the Internal Review Board of the Institutional Ethics Committee of Shanghai Jiao Tong University Affiliated Sixth Hospital and was conducted according to the World Medical Association Declaration of Helsinki in 1975, as revised in 1983.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interest.

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Wei, R., Gao, Z., Xu, H. et al. Body Fat Indices as Effective Predictors of Insulin Resistance in Obstructive Sleep Apnea: Evidence from a Cross-Sectional and Longitudinal Study. OBES SURG (2021).

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  • Obstructive sleep apnea
  • Insulin resistance
  • Body fat indices