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

Given the robust correlation between MAFLD and OSA, FSI may act as a potential indicator for OSA risk. Nevertheless, the correlation between FSI and OSA, along with the potential mediating mechanisms, remains unclear.

Our study examined 46,028 NHANES participants from 2005 to 2008 and 2015 to 2020. FSI-OSA correlation was assessed using weighted multivariate logistic regression models, restricted cubic spline curve analysis, threshold effects analysis, and subgroup analysis. We also conducted mediation studies to determine if waist-to-height ratio (WHtR) mediates the FSI-OSA relationship.

Each unit increase in the FSI was associated with a 36% higher odds of OSA (OR = 1.36; 95% CI: 1.31-1.42). FSI quartiles were positively associated with OSA in aggregate analyses, with adjustment for potential confounders. RCS curves and threshold studies showed a nonlinear link between FSI and OSA risk when FSI was steeper on the left side of the inflection point (- 1.108) and levelled out on the right. WHtR also partially mediated the FSI-OSA connection, accounting for 24.5% of the total effect.

FSI and OSA were positively correlated with nonlinear and threshold effects in this study. Elevated FSI values were associated with a higher risk of OSA.