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Published on: December 6, 2016
Association between cardiometabolic Index and obstructive sleep apnea and the mediating role of smoking: a
Yifan Zhou1, Jinghao Yu2, Haitao Tan1
1Department of Orthopedics, The 921st Hospital of the People's Liberation Army, The Second Affiliated Hospital of Hunan Normal University, Changsha, China.
Insights
The cardiometabolic index (CMI) is positively linked to obstructive sleep apnea (OSA) in US adults. Smoking partially mediates this connection, highlighting the importance of managing CMI to reduce OSA risk.
Area of Science:
- Cardiology
- Sleep Medicine
- Public Health
Background:
- The cardiometabolic index (CMI) is a key indicator of heart health and cardiovascular disease (CVD) risk.
- A gap exists in understanding the relationship between CMI and obstructive sleep apnea (OSA).
Purpose of the Study:
- To investigate the association between the cardiometabolic index (CMI) and obstructive sleep apnea (OSA) in a US adult population.
- To explore potential mediating factors, such as smoking, in the CMI-OSA relationship.
Main Methods:
- Cross-sectional study utilizing 2015-2018 National Health and Nutrition Examination Survey (NHANES) data.
- Obstructive sleep apnea (OSA) assessed using the NHANES Sleep Questionnaire (SLQ).
- Statistical analyses included logistic regression, restricted cubic splines, threshold effect, subgroup, and mediation analyses.
Main Results:
- A cohort of 3,912 adults (aged ≥20) was analyzed, with 51% diagnosed with OSA.
- A significant positive correlation was found between CMI and OSA prevalence (OR: 1.31; 95% CI: 1.21-1.42; p < 0.001).
- Threshold effect analysis revealed an inflection point, and smoking was identified as a significant mediator (effect size: 0.002115).
Conclusions:
- A positive, nonlinear relationship exists between CMI and OSA prevalence in US adults.
- Smoking status partially mediates the association between CMI and OSA.
- Maintaining CMI within an optimal range may reduce the risk of developing OSA.
Background:
The cardiometabolic Index (CMI) serves as a metric for evaluating the functional and metabolic health of the heart. It aids healthcare professionals in assessing cardiac health, predicting the risk of cardiovascular diseases, and determining the effectiveness of various treatments. Despite its significance, there is a scarcity of studies examining the relationship between CMI and obstructive sleep apnea (OSA). Consequently, our objective was to clarify the relationship between CMI and OSA.
Methods:
We conducted a cross-sectional study using data from the 2015-2018 National Health and Nutrition Examination Survey (NHANES), focusing on a cohort of adults aged 20 years and older. To assess the prevalence of OSA, we employed the Sleep Questionnaire (SLQ) included in the NHANES dataset, which identifies OSA based on symptom-based survey items. Various analytical methods were utilized to examine the relationship between CMI and OSA, including multivariate logistic regression, restricted cubic splines (RCS), threshold effect analysis, subgroup analyses, and mediation effect analyses.
Results:
In this study, we included 3,912 participants, among whom 1,997 were diagnosed with OSA, resulting in a prevalence of 51%. After thoroughly accounting for relevant covariates, a positive correlation between the CMI and OSA was observed [OR (95% CI): 1.31 (1.21, 1.42), p < 0.001]. This association was further corroborated through restricted cubic spline (RCS) analyses. Additionally, threshold effect analyses indicated a significant inflection point, with the prevalence of OSA increasing significantly with CMI and then leveling off. Further subgroup analyses demonstrated a significant interaction based on smoking status (p < 0.05). Finally, mediation analyses confirmed that smoking served as a mediator in the relationship between CMI and OSA, exhibiting a mediation effect size of 0.002115.
Conclusion:
In the adult population of the United States, a positive nonlinear relationship exists between the CMI and the prevalence of OSA. Smoking status partially mediates this association. Additionally, the findings from the threshold effects analysis indicate that maintaining CMI within an appropriate range can significantly decrease the likelihood of developing OSA.
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