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European Respiratory Journal

2018 Nov - Obstructive sleep apnoea as a risk factor for incident metabolic syndrome: a joined Episono and HypnoLaus prospective cohorts study

Camila Hirotsu, Jose Haba-Rubio, Sonia M. Togeiro, Pedro Marques-Vidal, Luciano F. Drager, Peter Vollenweider, Gérard Waeber, Lia Bittencourt, Sergio Tufik, Raphael Heinzer


Eur Respir J. 2018 Oct 4. pii: 1801150


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.


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Camila Hirotsu, Jose Haba-Rubio, Sonia M. Togeiro, Pedro Marques-Vidal, Luciano F. Drager, Peter Vollenweider, Gérard Waeber, Lia Bittencourt, Sergio Tufik, Raphael Heinzer


Eur Respir J. 2018 Oct 4. pii: 1801150


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.


weblink here

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