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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

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A Correction to this article was published on 22 March 2021

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Abstract

Purpose

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.

Results

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).

Conclusions

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

Graphical abstract

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Data Availability

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

Change history

Abbreviations

OSA:

obstructive sleep apnea

PSG:

polysomnography

BMI:

body mass index

NC:

neck circumference

WC:

waist circumference

HC:

hip circumference

WHR:

waist-hip rate

WHtR:

waist height rate

TC:

total cholesterol

TG:

triglycerides

HDL:

high-density lipoprotein cholesterol

LDL:

low-density lipoprotein cholesterol

LAP:

lipid accumulation product

VAI:

visceral adiposity index

TyG:

triglycerides and glucose index

HOMA-IR:

homeostasis model assessment index of insulin resistance

AHI:

apnea-hypopnea index

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Acknowledgments

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

Funding

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).

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Author notes

  1. Ruobing Wei and Zhenfei Gao contributed equally to this work.

Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery & Center of Sleep Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Yishan Road 600, Shanghai, 200233, China

    Ruobing Wei, Xinyi Li, Huaming Zhu & Shankai Yin

  2. Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China

    Zhenfei Gao, Yupu Liu & Hongliang Yi

  3. Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China

    Huajun Xu, Jianyin Zou & Jian Guan

  4. Shanghai, China

    Cuiping Jiang

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  1. Ruobing Wei
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Contributions

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 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.

Informed Consent

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

Competing Interest

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 31, 2219–2230 (2021). https://doi.org/10.1007/s11695-021-05261-9

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