Sun Huixian, Zeng Xin, Gao Wei, Lu Xiang
Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, No.109 Longmian Avenue, Nanjing, Jiangsu, 211166, China.
Department of Geriatrics, School of Medicine, Zhongda Hospital, Southeast University, No.87 Dingjiaqiao, Nanjing, Jiangsu, 210009, China.
Aging Clin Exp Res. 2025 Mar 8;37(1):68. doi: 10.1007/s40520-025-02963-3.
Evidence for a causal relationship between sarcopenia and obstructive sleep apnea (OSA) is scarce. This study aimed to investigate the causal association between sarcopenia-related traits and OSA utilizing Mendelian randomization (MR) analyses.
MR analyses were conducted using genetic instruments for sarcopenia-related traits, including hand grip strength, muscle mass, fat mass, water mass, and physical performance. Data from large-scale genome-wide association studies (GWAS) were utilized to identify genetic variants associated with these traits. Causal associations with OSA were assessed using various MR methods, including the inverse variance-weighted (IVW) method, MR-Egger, and weighted median approaches. Pleiotropy and heterogeneity were evaluated through MR-PRESSO and other sensitivity analyses.
Low hand grip strength in individuals aged 60 years and older exhibited a positive correlation with the risk of OSA (IVW, OR = 1.190, 95% CI = 1.003-1.413, p = 0.047), while no significant causal effects were observed for grip strength in the left and right hands. Muscle mass, fat mass, and water mass were significantly associated with OSA, even after adjusting for multiple testing. Notably, higher levels of body fat percentage, trunk fat percentage, and limb fat percentage were strongly correlated with increased risk of OSA. Physical performance indicators such as walking pace demonstrated an inverse association with OSA, while a higher risk of OSA was observed with increased log odds of falling risk and greater frequency of falls in the last year. Additionally, a causal effect was found between long-standing illness, disability, or infirmity and OSA.
This comprehensive MR analysis provides evidence of a significant causal relationship between characteristics associated with sarcopenia, including low hand grip strength, muscle mass, fat mass, and physical performance, and the risk of OSA. These findings underscore the importance of addressing sarcopenia-related factors in the management and prevention of OSA.
肌肉减少症与阻塞性睡眠呼吸暂停（OSA）之间因果关系的证据稀少。本研究旨在利用孟德尔随机化（MR）分析来探究与肌肉减少症相关的特征与OSA之间的因果关联。
使用与肌肉减少症相关特征的遗传工具进行MR分析，这些特征包括握力、肌肉量、脂肪量、水分量和身体机能。利用大规模全基因组关联研究（GWAS）的数据来识别与这些特征相关的基因变异。使用各种MR方法评估与OSA的因果关联，包括逆方差加权（IVW）法、MR-Egger法和加权中位数法。通过MR-PRESSO和其他敏感性分析评估多效性和异质性。
60岁及以上个体的低握力与OSA风险呈正相关（IVW，OR = 1.190，95%CI = 1.003 - 1.413，p = 0.047），而左右手的握力未观察到显著的因果效应。即使在进行多重检验校正后？[此处原文“even after adjusting for multiple testing”表述不太完整准确，推测是想说校正后，肌肉量、脂肪量和水分量与OSA仍显著相关]，肌肉量、脂肪量和水分量仍与OSA显著相关。值得注意的是，较高的体脂百分比、躯干脂肪百分比和四肢脂肪百分比与OSA风险增加密切相关。诸如步行速度等身体机能指标与OSA呈负相关，而去年跌倒风险的对数优势增加和跌倒频率更高时，观察到OSA风险更高。此外，在长期疾病、残疾或体弱与OSA之间发现了因果效应。
这项全面的MR分析提供了证据，表明与肌肉减少症相关的特征，包括低握力、肌肉量、脂肪量和身体机能，与OSA风险之间存在显著的因果关系。这些发现强调了在OSA的管理和预防中解决与肌肉减少症相关因素的重要性。
