Association between the framingham steatosis index and obstructive sleep apnea: a population-based study

Area of Science:

• Metabolic and Sleep Medicine
• Public Health Research

Background:

• Non-alcoholic fatty liver disease (NAFLD) and obstructive sleep apnea (OSA) show a strong correlation.
• The role of the fatty liver index (FSI) as an indicator for OSA risk requires further investigation.
• Mechanisms underlying the FSI-OSA relationship are not fully understood.

Purpose of the Study:

• To investigate the correlation between the fatty liver index (FSI) and obstructive sleep apnea (OSA).
• To explore potential mediating factors, such as waist-to-height ratio (WHtR), in the FSI-OSA relationship.
• To analyze the nature of the association, including nonlinearity and threshold effects.

Main Methods:

• Analysis of 46,028 participants from the NHANES database (2005-2008, 2015-2020).
• Weighted multivariate logistic regression, restricted cubic spline (RCS) analysis, and threshold effects analysis were employed.
• Mediation analysis was conducted to assess the role of WHtR.

Main Results:

• A significant positive correlation was found between FSI and OSA risk (OR=1.36).
• RCS and threshold analyses revealed a nonlinear association between FSI and OSA, with a steeper increase in risk at lower FSI values.
• Waist-to-height ratio (WHtR) partially mediated 24.5% of the FSI-OSA association.

Conclusions:

• The study confirms a positive, nonlinear correlation between FSI and OSA.
• Elevated FSI is associated with an increased risk of OSA.
• WHtR plays a partial mediating role in this relationship.