Nocturnal Intermittent Hypoxia and Metabolic Syndrome; the Effect of being Overweight: the CIRCS Study

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  • Muraki Isao
    Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine. Osaka Medical Center for Health Science and Promotion.
  • Tanigawa Takeshi
    Department of Public Health, Doctoral Program in Social Medicine, Graduate School of Medicine, Ehime University.
  • Yamagishi Kazumasa
    Department of Public Health Medicine, Graduate School of Comprehensive Human Sciences, and Institute of Community Medicine, University of Tsukuba.
  • Sakurai Susumu
    Department of Public Health, Doctoral Program in Social Medicine, Graduate School of Medicine, Ehime University.
  • Ohira Tetsuya
    Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine.
  • Imano Hironori
    Osaka Medical Center for Health Science and Promotion.
  • Kiyama Masahiko
    Osaka Medical Center for Health Science and Promotion.
  • Kitamura Akihiko
    Osaka Medical Center for Health Science and Promotion.
  • Sato Shinichi
    Osaka Medical Center for Health Science and Promotion. Chiba Prefectural Institute of Public Health.
  • Shimamoto Takashi
    Osaka Medical Center for Health Science and Promotion.
  • Konishi Masamitsu
    Osaka Medical Center for Health Science and Promotion.
  • Iso Hiroyasu
    Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine.

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Abstract

Aim: We investigated whether nocturnal intermittent hypoxia, a surrogate marker for obstructive sleep apnea, is associated with metabolic syndrome and its components among Japanese.<BR>Methods: We examined 1,710 male and 2,896 female community-dwelling Japanese aged 40 to 69, who participated in annual cardiovascular examinations and investigations of sleep. Nocturnal intermittent hypoxia was estimated based on a 3% oxygen desaturation index measured with pulse-oximetry during sleep. No, mild and moderate-to-severe nocturnal intermittent hypoxia were defined by <5, 5 to <15 and ≥15 events/hour, respectively. Metabolic syndrome was defined by modified criteria of the Adult Treatment Panel III guidelines.<BR>Results: Compared with no nocturnal intermittent hypoxia, the multivariable odds ratio of metabolic syndrome was 1.9 (95% confidence interval: 1.6-2.4) for mild and 3.2 (2.2-4.7) for moderate-to-severe nocturnal intermittent hypoxia among men; 2.6 (2.1-3.4) and 5.8 (3.4-9.8) among women, respectively. When stratified by overweight status (body mass index ≥25 kg/m2), the multivariable odds ratio of two or more metabolic risk factors (other than overweight) associated with moderate-to-severe nocturnal intermittent hypoxia was 1.9 (1.2-3.1) among non-overweight subjects and 1.4 (0.9-2.1) among overweight subjects (p for interaction=0.002).<BR>Conclusions: Nocturnal intermittent hypoxia was associated with the accumulation of metabolic risk factors, especially among non-overweight individuals.

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