Dataset Information

The correlation between frailty index and incidence, mortality in obstructive sleep apnea: Evidence from NHANES.

ABSTRACT:

Background

The emergence of obstructive sleep apnea (OSA) is marked by a growing trend towards younger individuals, while its developmental trajectory remains shrouded in uncertainty, accompanied by intricate prognostic implications. While frailty and sleep problems often coexist, the relationship between them remains unclear. Hence, this study aims to utilize the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2008 to analyze and explore the relationship between the level of frailty index (FI) and the risk of OSA incidence and survival outcomes.

Materials and methods

Specialized weighted complex survey design analysis software was employed for data analysis. Multivariate logistic regression models and restricted cubic splines (RCS) were utilized to assess the association between FI and OSA incidence in all participants. Additionally, a Cox proportional hazards model was established to estimate the association between FI and the hazard ratios (HRs) for all-cause mortality and cardiovascular disease (CVD) mortality.

Results

A total of 8524 participants were included in this study. Compared to the Non-frail group (FI ≤ 0.1), OSA risk increased with higher FI levels. In Model 3, adjusted for multiple covariates, the Pro-frail group (0.1 0.3) [OR = 2.32, 95 % CI (1.55, 3.48)] exhibited an average 31 %, 62 %, and 132 % increase in OSA risk, respectively. RCS results demonstrated a nonlinear dose-response relationship between OSA risk and FI levels, with an increasing trend (P = 0.004). The Cox model indicated that, except for the Pro-frail group, OSA-related mortality risk also increased with higher FI levels, with a more pronounced effect on CVD-related mortality.

Conclusion

This study supports the hypothesis that FI may be associated with an increased risk of OSA, with a higher emphasis on OSA-related mortality risk in Mildly frail and Moderately/Severely frail populations.

SUBMITTER: Yan Z

PROVIDER: S-EPMC11341328 | biostudies-literature | 2024 Jun

REPOSITORIES: biostudies-literature

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Publications

The correlation between frailty index and incidence, mortality in obstructive sleep apnea: Evidence from NHANES.

Yan Zhaoqi Z Xu Yifeng Y Li Keke K Liu Liangji L

Heliyon 20240606 12

<h4>Background</h4>The emergence of obstructive sleep apnea (OSA) is marked by a growing trend towards younger individuals, while its developmental trajectory remains shrouded in uncertainty, accompanied by intricate prognostic implications. While frailty and sleep problems often coexist, the relationship between them remains unclear. Hence, this study aims to utilize the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2008 to analyze and explore the relationship ...[more]

PMID: 39183837

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Project description:Insulin resistance (IR) is strongly associated with obstructive sleep apnea (OSA). Whereas, few studies have focused on the potential association between the Metabolic Score for Insulin Resistance (METS-IR), a novel non-insulin-dependent IR index, and OSA. Subjects from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2008 and 2015-2018 were recruited. The potential relationship between METS-IR and other IR indices with OSA was explored through three logistic regression analysis models and restricted cubic spline (RCS) curves. Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of these indicators for OSA. On the basis of age, sex, race, body mass index (BMI), hypertension, diabetes， and cardiovascular disease (CVD), subgroup analyses were conducted to test the robustness of the METS-IR and OSA relationship. A total of 8,306 participants were enrolled, with an OSA prevalence of 30.69%. After adjusting for potential confounders, METS-IR, the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, the triglyceride glucose Index (TyG), and the homeostatic model assessment of insulin resistance (HOMA-IR) showed positive associations with OSA prevalence. In the highest tertile of METS-IR, TG/HDL-C, TyG index, and HOMA-IR, OSA prevalence was 2.96-fold, 1.42-fold, 1.29-fold, and 1.41-fold higher, respectively, compared to the lowest tertile (METS-IR: OR = 2.96, 95% CI: 2.50, 3.52, P < 0.0001; TG/HDL-C: OR = 1.42, 95% CI: 1.17, 1.73, P < 0.001; TyG index: OR = 1.29, 95% CI: 1.07, 1.55, P = 0.008; HOMA-IR: OR = 1.41, 95% CI: 1.18, 1.69, P < 0.001). ROC analysis revealed that METS-IR had the highest diagnostic accuracy for OSA (AUC = 0.652). The positive associations between these four IR indices and OSA remain stable across most cases (P for interaction > 0.05); however, all of them show significant interactions with diabetes (P for interaction < 0.05). The METS-IR index is positively associated with the prevalence of OSA and shows superior diagnostic accuracy compared to HOMA-IR, TG/HDL-C, and TyG index.

Project description:Introduction: Obstructive sleep apnea (OSA) is a serious condition linked with various metabolic disorders and associated with increased all-cause and cardiovascular mortality. Although the potential mechanisms of pathophysiological processes related to OSA are relatively well known, the data regarding the correlation between obstructive sleep apnea, dyslipidemia, and systemic inflammation are still inconclusive. Methods: The study was conducted as a retrospective cohort study including 328 patients with newly diagnosed obstructive sleep apnea during the period between April 2018, and May 2020, in University Clinical Hospital Center "Bezanijska kosa", Belgrade, Serbia. Polysomnography was performed in all patients according to the protocol. Numerous demographic, antropometric, laboratory, and clinical data were correlated to Apnea-Hypopnea Index (AHI) as a dependent variable, with a particular review on the relation between lipid abnormalities, inflammatory parameters, and obstructive sleep apnea severity. Multivariate logistic regression model was used to assess predictors of severe OSA (AHI ≥30 per hour). Results: A total of 328 patients were included in the study. The mean age of the patients was 54.0 ± 12.5 years and more than two-thirds were male (68.8%). The majority of the patients had an AHI of at least 30 events per hour. Patients with severe OSA were more frequently male, obese, hypertensive and hyperlipidemic, and had increased neck circumference (both male and female patients). One hundred and thirty-two patients had metabolic syndrome. Patients with severe OSA more frequently had metabolic syndrome and significantly higher levels of glucose, creatinine, uric acid, AST, ALT, CK, microalbumine/creatinine ratio, triglyceride, total cholesterol, HDL, total cholеsterol to HDL-C ratio, CRP, and ESR. In the multivariate linear regression model with AHI (≥30 per hour) as a dependent variable, of demographic and clinical data, triglycerides ≥1.7 mmol/L and CRP >5 mg/L were significantly associated with AHI≥30 per hour. Conclusion: The present study on 328 patients with newly diagnosed obstructive sleep apnea revealed significant relation of lipid abnormalities, inflammatory markers, and other clinically important data with obstructive sleep apnea severity. These results can lead to a better understanding of the underlying pathophysiological processes and open the door to a new world of potentially useful therapeutic modalities.

Dataset Information

The correlation between frailty index and incidence, mortality in obstructive sleep apnea: Evidence from NHANES.

Background

Materials and methods

Results

Conclusion

Publications

The correlation between frailty index and incidence, mortality in obstructive sleep apnea: Evidence from NHANES.

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