Skip to main content
SpringerLink
Log in

Anthropometric Factors in the Assessment of Obstructive Sleep Apnea Risk in Patients with Metabolic Syndrome

  • Chapter
  • First Online:
Advances in Pulmonary Medicine: Research and Innovations

Part of the book series: Advances in Experimental Medicine and Biology ((NR,volume 1160))

Abstract

Metabolic syndrome (MetS) and obstructive sleep apnea (OSA) are related to a higher incidence of cardio-vascular diseases and mortality in patients. The aim of the study was to define the potential use of anthropometric factors for the evaluation of OSA risk in patients with diagnosed MetS. The patient group consisted of 50 obese men with MetS (mean age 49 ± 9 years). The following anthropometric indices were assessed: body mass index (BMI), neck circumference (NC), waist circumference (WC), and waist-to-hip ratio (WHR). In addition, blood glucose and lipid profile were investigated. On the basis of polysomnography, clinical symptoms, and Epworth Sleep Scale, patients were stratified into the OSA group accompanied by MetS (n = 31) and the MetS alone group taken as control (n = 19). OSA was evaluated as severe in 26 out of the 31 patients (>30 apneic episodes per hour). We found a significantly larger NC in the OSA with MetS group then that in the MetS alone group. Further, NC associated with the increase in the apnea/hypopnea index. However, the other anthropometric indices investigated failed to differentiate the two groups. We conclude that increased neck circumference in patients suffering from metabolic syndrome is a risk factor for the development of OSA.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • AASM (2014) American Academy of Sleep Medicine. International classification of sleep disorders, 3rd edn. American Academy of Sleep Medicine, Darien

    Google Scholar 

  • Bixler EO, Vgontzas AN, Ten Have T, Tyson K, Kales A (1998) Effects of age on sleep apnea in men: I. Prevalence and severity. Am J Respir Crit Care Med 157:144–148

    Article  CAS  Google Scholar 

  • Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Rein J, Vela–Bueno A, Kales A (2001) Prevalence of sleep–disordered breathing in women: effects of gender. Am J Respir Crit Care Med 163:608–613

    Article  CAS  Google Scholar 

  • Bixler EO, Vgontzas AN, Lin HM, Calhoun SL, Vela–Bueno A, Kales A (2005) Excessive daytime sleepiness in a general population sample: the role of sleep apnea, age, obesity, diabetes, and depression. J Clin Endocrinol Metab 90:4510–4515

    Article  CAS  Google Scholar 

  • Bonsignore MR, Borel AL, Machan E, Grunstein R (2013) Sleep and breathing. Eur Respir Rev 22:353–364

    Article  Google Scholar 

  • Cizza G, de Jonge L, Piaggi P, Mattingly M, Zhao X, Lucassen E, Rother KI, Sumner AE, Csako G, NIDDK Sleep Extension Study (2014) Neck circumference is a predictor of metabolic syndrome and obstructive sleep apnea in short–sleeping obese men and women. Metab Syndr Relat Disord 12:231–241

    Article  CAS  Google Scholar 

  • Coughlin S, Calverley P, Wilding J (2001) Sleep disordered breathing – a new component of syndrome x? Obes Rev 2:267–274

    Article  CAS  Google Scholar 

  • Coughlin SR, Mawdsley L, Mugarza JA, Calverley PM, Wilding JP (2004) Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J 25:735–741

    Article  Google Scholar 

  • Davies JO, Ali NJ, Stradling JR (1992) Neck circumference and other clinical features in the diagnosis of the obstructive sleep apnoea syndrome. Thorax 47:101–105

    Article  CAS  Google Scholar 

  • Deegan PC, McNicholas WT (1995) Pathophysiology of obstructive sleep apnoea. Eur Respir J 8:1161–1178

    Article  CAS  Google Scholar 

  • Drager LF, Queiroz EL, Lopes HF, Genta PR, Krieger EM, Lorenzi–Filho G (2009) Obstructive sleep apnea is highly prevalent and correlates with impaired glycemic control in consecutive patients with the metabolic syndrome. J Cardiometab Syndr 4:89–95

    Article  Google Scholar 

  • Drager LF, Lopes HF, Maki–Nunes C, Trombetta IC, Toschi–Dias E, Alves MJ, Fraga RF, Jun JC, Negrão CE, Krieger EM, Polotsky VY, Lorenzi–Filho G (2010) The impact of obstructive sleep apnea on metabolic and inflammatory markers in consecutive patients with metabolic syndrome. PLoS One 5(8):e12065

    Article  Google Scholar 

  • Drager LF, Polotsky VY, O’Donnell CP, Cravo SL, Lorenzi–Filho G, Machado BH (2015) Translational approaches to understanding metabolic dysfunction and cardiovascular consequences of obstructive sleep apnea. Am J Physiol Heart Circ Physiol 309(7):H1101–H1111

    Article  CAS  Google Scholar 

  • Flemons WW, Whitelaw WA, Brant R, Remmers JE (1994) Likelihood ratios for a sleep apnea clinical prediction rule. Am J Respir Crit Care Med 150(Pt 1):1279–1285

    Article  CAS  Google Scholar 

  • Formiguera X, Canton A (2004) Obesity: epidemiology and clinical aspects. Best Pract Res Clin Gastroenterol 18:1125–1146

    Article  Google Scholar 

  • Gaines J, Vgontzas AN, Fernandez–Mendoza J, Bixler EO (2018) Obstructive sleep apnea and the metabolic syndrome: the road to clinically–meaningful phenotyping, improved prognosis, and personalized treatment. Sleep Med Rev 42:211–219

    Article  Google Scholar 

  • Gami AS, Somers VK (2004) Obstructive sleep apnoea, metabolic syndrome, and cardiovascular outcomes. Eur Heart J 25:709–711

    Article  Google Scholar 

  • Gruber A, Horwood F, Sithole J, Ali NJ, Idris I (2006) Obstructive sleep apnoea is independently associated with the metabolic syndrome but not insulin resistance state. Cardiovasc Diabetol 5:22

    Article  CAS  Google Scholar 

  • Huang PL (2009) A comprehensive definition for metabolic syndrome. Dis Model Mech 2:231–237

    Article  CAS  Google Scholar 

  • Jaspinder K (2014) A comprehensive review on metabolic syndrome. Cardiol Res Pract 2014:943162

    Google Scholar 

  • Kritikou I, Basta M, Tappouni R, Pejovic S, Fernandez–Mendoza J, Nazir R, Shaffer ML, Liao D, Bixler EO, Chrousos GP, Vgontzas AN (2013) Sleep apnoea and visceral adiposity in middle–aged male and female subjects. Eur Respir J 41:601–609

    Article  CAS  Google Scholar 

  • Kritikou I, Basta M, Vgontzas AN, Pejovic S, Liao D, Tsaoussoglou M, Bixler EO, Stefanakis Z, Chrousos GP (2014) Sleep apnoea, sleepiness, inflammation and insulin resistance in middle aged males and females. Eur Respir J 43:145–155

    Article  Google Scholar 

  • Lubrano C, Saponara M, Barbaro G, Specchia P, Addessi E, Costantini D, Tenuta M, Di Lorenzo G, Genovesi G, Donini LM, Lenzi A, Gnessi L (2012) Relationships between body fat distribution, epicardial fat and obstructive sleep apnea in obese patients with and without metabolic syndrome. PLoS One 7:e47059

    Article  CAS  Google Scholar 

  • Lui MM, Lam JC, Mak HK, Xu A, Ooi C, Lam DC, Mak JC, Khong PL, Ip MS (2009) C–reactive protein is associated with obstructive sleep apnea independent of visceral obesity. Chest 135:950–956

    Article  CAS  Google Scholar 

  • Peppard PE, Young T, Palta M, Dempsey J, Skatrud J (2000) Longitudinal study of moderate weight change and sleep–disordered breathing. JAMA 284:3015–3021

    Article  CAS  Google Scholar 

  • Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM (2013) Increased prevalence of sleep–disordered breathing in adults. Am J Epidemiol 177:1006–1014

    Article  Google Scholar 

  • Pływaczewski R, Brzecka A, Bielicki P, Czajkowska–Malinowska M, Cofta S, Jonczak L, Radliński J, Tażbirek M, Wasilewska J, Polish Society of Lung Diseases (2013) Sleep related breathing disorders in adults – recommendations of Polish Society of Lung Diseases. Pneumonol Alergol Pol 81(3):221–258. (Article in Polish)

    PubMed  Google Scholar 

  • Poelkens F, Lammers G, Pardoel EM, Tack CJ, Hopman MT (2013) Upregulation of skeletal muscle inflammatory genes links inflammation with insulin resistance in women with the metabolic syndrome. Exp Physiol 98:1485–1494

    Article  CAS  Google Scholar 

  • Qian Y, Xu H, Wang Y, Yi H, Guan J, Yin S (2016) Obstructive sleep apnea predicts risk of metabolic syndrome independently of obesity: a meta–analysis. Arch Med Sci 12(5):1077–1087

    Article  Google Scholar 

  • Ridker PM, Buring JE, Cook NR, Rifai N (2003) C–reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8–year followup of 14 719 initially healthy American women. Circulation 107:391–397

    Article  Google Scholar 

  • Shamsuzzaman AS, Gersh BJ, Somers VK (2003) Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA 290:1906–1914

    Article  CAS  Google Scholar 

  • Soylu AC, Levent E, Sariman N, Yurtlu S, Alparslan S, Saygı A (2012) Obstructive sleep apnea syndrome and anthropometric obesity indexes. Sleep Breath 16:1151–1158

    Article  Google Scholar 

  • Stabe C, Vasques AC, Lima MM, Tambascia MA, Pareja JC, Yamanaka A, Geloneze B (2013) Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: results from the Brazilian Metabolic Syndrome Study. Clin Endocrinol 78:874–881

    Article  CAS  Google Scholar 

  • Tażbirek M, Słowińska L, Kawalski M, Pierzchała W (2011) The rheological properties of blood and the risk of cardiovascular disease in patients with obstructive sleep apnea syndrome (OSAS). Folia Histochem Cytobiol 49:206–210

    Article  Google Scholar 

  • Venkateswaran S, Shankar P (2007) The prevalence of syndrome Z (the interaction of obstructive sleep apnoea with the metabolic syndrome) in a teaching hospital in Singapore. Postgrad Med J 83:329–331

    Article  Google Scholar 

  • Vgontzas AN (2008) Excessive daytime sleepiness in sleep apnea: it is not justapnea hypopnea index. Sleep Med 9:712–714

    Article  Google Scholar 

  • Vgontzas AN, Papanicolaou DA, Bixler EO, Hopper K, Lotsikas A, Lin HM, Kales A, Chrousos GP (2000) Sleep apnea and daytime sleepiness and fatigue: relation to visceral obesity, insulin resistance, and hypercytokinemia. J Clin Endocrinol Metab 85:1151–1158

    Article  CAS  Google Scholar 

  • Vgontzas AN, Bixler EO, Chrousos GP (2005) Sleep apnea is a manifestation of the metabolic syndrome. Sleep Med Rev 9:211–224

    Article  Google Scholar 

  • Wajchenberg BL (2000) Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 21:697e738

    Article  Google Scholar 

  • Wilcox I, McNamara SG, Collins FL, Grunstein RR, Sullivan CE (1998) “Syndrome Z”: the interaction of sleep apnoea, vascular risk factors and heart disease. Thorax 53(Suppl 3):S25–S28

    PubMed  PubMed Central  Google Scholar 

  • Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep–disordered breathing among middle–aged adults. N Engl J Med 328:1230–1235

    Article  CAS  Google Scholar 

Download references

Conflicts of interest

The authors declare no conflicts of interest in relation to this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of Medical University of Silesia.

Consent

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

Author information

Authors and Affiliations

  1. Department of Pneumology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland

    M. Tażbirek, W. Pierzchała & A. Barczyk

  2. Student Scientific Circle, Department of Pneumology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland

    J. Potoczny & K. Strójwąs

Authors
  1. M. Tażbirek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Potoczny
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Strójwąs
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W. Pierzchała
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Barczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Tażbirek .

Editor information

Editors and Affiliations

  1. Opole Medical School, Opole, Poland

    Mieczyslaw Pokorski

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Tażbirek, M., Potoczny, J., Strójwąs, K., Pierzchała, W., Barczyk, A. (2019). Anthropometric Factors in the Assessment of Obstructive Sleep Apnea Risk in Patients with Metabolic Syndrome. In: Pokorski, M. (eds) Advances in Pulmonary Medicine: Research and Innovations. Advances in Experimental Medicine and Biology(), vol 1160. Springer, Cham. https://doi.org/10.1007/5584_2019_376

Download citation

Publish with us

Policies and ethics

Search

Navigation