Sleep disordered breathing as an integral part of metabolic syndrome
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Sleep disordered breathing (SDB) is an obesity comorbidity and an independent risk factor for type 2 diabetes and cardiovascular disease, being associated with cardiovascular risk factors such as hypertension, enlarged waist, relative/absolute/visceral fat, liver steatosis and hypoandrogenicity. To examine the association between SDB and the prevalence of metabolic syndrome (NCEP ATP III), vascular and metabolic functions were measured in 546 subjects participating in the Wisconsin Sleep Cohort Study. SDB was characterized by the apnoea-hypopnoea index (AHI) obtained during the polysomnography study, and the homeostasis model assessment method (HOMA) was used to define insulin resistance. SDB significantly correlated with insulin resistance. Compared with subjects without SDB, the adjusted odds ratio of metabolic syndrome associated with mild SDB was 4.0, and that associated with moderate/severe SDB was 5.3. These estimates were not altered by additional adjustments for markers of sympathetic or neuroendocrine activation. After adjusting for body mass index, these associations became weaker, but remained statistically significant. This study suggests that SDB might be considered as an integral part of metabolic syndrome phenotype.
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