Association Between Sleep Apnea Risk and Obesity Phenotypes in Korean Adults: A Nationwide Population-Based Study

Area of Science:

• Obesity research
• Sleep medicine
• Public health epidemiology

Background:

• Obesity phenotypes and their association with sleep apnea risk require further investigation.
• Understanding these relationships is crucial for targeted public health interventions in the Korean population.

Purpose of the Study:

• To analyze the relationship between distinct obesity phenotypes and the risk of sleep apnea.
• To evaluate the impact of metabolic health status, independent of body mass index (BMI), on sleep apnea risk.

Main Methods:

• Utilized data from 10,970 Korean adults (age ≥ 40 years) from the 2019-2021 KNHANES.
• Classified participants into four obesity phenotypes: metabolically healthy normal weight (MHNW), metabolically abnormal normal weight (MANW), metabolically healthy obese (MHO), and metabolically abnormal obese (MAO).
• Assessed sleep apnea risk using the STOP-Bang questionnaire and employed multivariate logistic regression.

Main Results:

• The metabolically abnormal obese (MAO) phenotype exhibited the highest sleep apnea risk (aOR 10.27), followed by MHO (aOR 6.17) and MANW (aOR 1.91), compared to MHNW.
• Metabolically abnormal groups (MANW and MAO) were older and had more cardiometabolic risk factors.
• Mean STOP-Bang scores increased significantly from MHNW to MAO, indicating a dose-response relationship.

Conclusions:

• Obesity phenotypes significantly influence sleep apnea risk in Korean adults.
• Metabolic dysfunction contributes to sleep apnea risk independently of BMI, suggesting its importance in risk stratification.
• Targeting metabolic health may be a key strategy for managing sleep apnea risk.