Obstructive sleep apnoea as a risk factor for incident metabolic syndrome: a joined Episono and HypnoLaus prospective cohorts study

Author(s)

Hirotsu, Camila ^{[1, 2]} ; Haba-Rubio, Jose ^[2] ; Togeiro, Sonia M. ^[1] ; Marques-Vidal, Pedro ^[3] ; Drager, Luciano F. ^{[4, 5]} ; Vollenweider, Peter ^[3] ; Waeber, Gerard ^[3] ; Bittencourt, Lia ^[1] ; Tufik, Sergio ^[1] ; Heinzer, Raphael ^{[2, 6]}

Affiliation

^[1] Univ Fed Sao Paulo UNIFESP, Dept Psychobiol, Sao Paulo - Brazil

^[2] Univ Hosp Lausanne CHUV, CIRS, Lausanne - Switzerland

^[3] Univ Hosp Lausanne CHUV, Dept Internal Med, Lausanne - Switzerland

^[4] Univ Sao Paulo, Med Sch, Heart Inst InCor, Hypertens Unit, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Med Sch, Renal Div, Sao Paulo - Brazil

^[6] Univ Hosp Lausanne CHUV, Pulm Dept, Lausanne - Switzerland

• Document type: Journal article
• Source: European Respiratory Journal; v. 52, n. 5 NOV 1 2018.
• Web of Science Citations: 2

Abstract

Cross-sectional studies have demonstrated that obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) are often associated, but whether a temporal relationship exists is unknown. We aimed to investigate the effect of OSA on the risk of developing MetS in the general population. A prospective study was conducted combining two population-based samples: Episono (Brazil) and HypnoLaus (Switzerland). MetS was assessed according to unified criteria. Polysomnography (PSG) was performed at baseline and follow-up in Episono, and at baseline in HypnoLaus. OSA was defined according to the apnoea-hypopnoea index as mild (>= 5-<15 events h(-1)) and moderate-to-severe (>= 15 events.h(-1)). We included 1853 participants (mean +/- SD age 52 +/- 13 years, 56% female) without MetS at baseline. After mean +/- SD 6 +/- 1 years, 318 (17.2%) participants developed MetS. Moderate-to-severe OSA was independently associated with incident MetS (OR 2.58, 95% CI 1.61-4.11) and increased the number of MetS components from baseline to follow-up through mediation of the percentage of time with arterial oxygen saturation <90%. Subset analysis in Episono confirmed that the increase in this parameter between baseline and follow-up PSGs represented a risk factor for incident MetS (OR 1.42, 95% CI 1.04-1.95, for each 10% increase). OSA is independently associated with an increased risk of developing MetS through mediation of nocturnal hypoxaemia in the general population. (AU)

• FAPESP's process: 14/15259-2 - Epidemiology of sleep in the city of São Paulo: follow-up of volunteers from the population-based study EPISONO
• Grantee: Camila Hirotsu
• Support type: Scholarships in Brazil - Post-Doctorate