Pejovic Slobodanka, Vgontzas Alexandros N, Fernandez-Mendoza Julio, He Fan, Li Yun, Bixler Edward O
Sleep Research & Treatment Center, Penn State Health Milton S. Hershey Medical Center, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania.
J Clin Sleep Med. 2025 Aug 1;21(8):1371-1378. doi: 10.5664/jcsm.11698.
It has been described a bi-directional association between obstructive sleep apnea (OSA) and metabolic syndrome (MetS), both promoting atherosclerosis and cardiovascular disease. Given that cardiometabolic comorbidities associated with OSA tend to diminish with age, in this study we examined whether the association of OSA with MetS is modified by age and body weight.
We studied 1,741 adults from the Penn State Adult Cohort (age 20-88 years) who underwent a 1-night polysomnography, clinical history, and physical examination in a cross-sectional design. The presence of OSA was defined as an apnea-hypopnea index ≥ 15 events/h. Outcome variables include the 5 MetS components (obesity [≥ 30kg/m], hypertension [≥ 130/85 mm Hg], hyperglycemia [fasting blood sugar (FBS) ≥ 100 mg/dL], hypercholesterolemia [≥ 200 mg/dL], and hypertriglyceridemia [≥ 150 mg/dL]). Logistic regression models examined the association of OSA with MetS components adjusting for confounders.
There was a significant interaction between OSA and age on MetS. In young and middle-aged individuals (< 60 years old) but not in older individuals, OSA was significantly associated with MetS and its individual components, ie, hypertension (odds ratio [OR] = 3.85, 95% confidence interval [CI] = 1.95-7.63), hyperglycemia (OR = 5.62, 95% CI = 2.74-11.53), hypercholesterolemia (OR = 5.99, 95% CI = 2.36-15.21), and hypertriglyceridemia (OR = 4.75, 95% CI = 2.30-9.90). The association of OSA with body mass index was stronger in the young and middle-aged vs older group (OR = 6.03, 95% CI = 3.08-11.78 vs 2.47, 95% CI = 1.23-4.94, respectively). Similar age-related modifications were observed in nonobese individuals.
The strong association of OSA with MetS in young and middle-aged obese and nonobese adults, but not in older adults, suggests that MetS is key to the pathogenesis of OSA in young and middle-aged adults and should be a treatment priority.
Pejovic S, Vgontzas AN, Fernandez-Mendoza J, He F, Li Y, Bixler EO. Effect of age on the association of obstructive sleep apnea with metabolic syndrome among obese and nonobese adults. . 2025;21(8):1371-1378.
阻塞性睡眠呼吸暂停（OSA）与代谢综合征（MetS）之间存在双向关联，二者均会促进动脉粥样硬化和心血管疾病。鉴于与OSA相关的心脏代谢合并症往往会随着年龄增长而减轻，在本研究中，我们探讨了年龄和体重是否会改变OSA与MetS之间的关联。
我们对宾夕法尼亚州立大学成人队列中的1741名成年人（年龄在20 - 88岁之间）进行了研究，这些人采用横断面设计接受了为期1晚的多导睡眠图检查、临床病史采集和体格检查。OSA的存在定义为呼吸暂停低通气指数≥15次/小时。结果变量包括5个MetS组分（肥胖[≥30kg/m]、高血压[≥130/85 mmHg]、高血糖[空腹血糖（FBS）≥100 mg/dL]、高胆固醇血症[≥200 mg/dL]和高甘油三酯血症[≥150 mg/dL]）。逻辑回归模型在调整混杂因素后检验了OSA与MetS组分之间的关联。
OSA与年龄在MetS方面存在显著交互作用。在年轻和中年个体（<60岁）中，而非老年个体中，OSA与MetS及其各个组分显著相关，即高血压（比值比[OR]=3.85，95%置信区间[CI]=1.95 - 7.63）、高血糖（OR = 5.62，95% CI = 2.74 - 11.53）、高胆固醇血症（OR = 5.99，95% CI = 2.36 - 15.21）和高甘油三酯血症（OR = 4.75，95% CI = 2.30 - 9.90）。与老年组相比，年轻和中年组中OSA与体重指数的关联更强（分别为OR = 6.03，95% CI = 3.08 - 11.78和OR = 2.47，95% CI = 1.23 - 4.94）。在非肥胖个体中也观察到了类似的与年龄相关的变化。
OSA与年轻和中年肥胖及非肥胖成年人的MetS密切相关，但与老年人无关，这表明MetS是年轻和中年成年人OSA发病机制的关键因素，应作为治疗的优先重点。
Pejovic S, Vgontzas AN, Fernandez-Mendoza J, He F, Li Y, Bixler EO. Effect of age on the association of obstructive sleep apnea with metabolic syndrome among obese and nonobese adults.. 2025;21(8):1371 - 1378.
