Different clinical parameters inform epicardial fat thickness in pre- and post-menopausal women with obstructive sleep apnea

Yong Zhang,Juan Li,Zhenxia Zhang,Jian Wang,Jin Ma,Wen Shui

doi:10.1186/s12905-021-01384-4

Abstract

BackgroundObstructive sleep apnea (OSA) is a sleep-related disorder with breathing difficulties. Previous studies revealed that epicardial fat thickness (EFT) correlates with OSA severity. Interestingly, female patients display a stronger EFT-OSA correlation than males. The purpose of this study is to investigate the relationship between EFT and different clinical characteristics in pre- and post-menopausal women diagnosed with OSA.MethodsPatients diagnosed with OSA were divided into pre/early peri-menopausal (Group 1) and post/late peri-menopausal (Group 2) according to the menopause status. EFT was obtained from parasternal long-axis echocardiographic images. We also collected general clinical characteristics of patients involved in this study, and performed spearman correlation analysis to explore the correlations between EFT and the general clinical characteristics. We further applied Multiple stepwise linear regression analysis to explore the predictors for EFT in both groups.ResultsA total number of 23 and 59 patients were enrolled in Group 1 and Group 2 respectively. EFT in Group 2 was significantly higher than that of Group 1. In both groups, EFT was positively correlated with apnea–hypopnea index (AHI), percentage of total sleep time when blood oxygen saturation was less than 90% (T90), oxygen desaturation index (ODI) and glucose; while EFT was negatively correlated with mean and lowest SaO2 (oxygen saturation) levels. However, EFT was positively correlated with total cholesterol (TC) only in Group 1 and body mass index (BMI) only in Group2, respectively. Multiple stepwise linear regression analysis showed that AHI was independently associated with EFT in Group 1. However, both AHI and BMI were independent predictors of EFT in Group 2.ConclusionEFT was notably correlated with menopausal status in women with OSA. AHI was the independent predictor of EFT in women with OSA. BMI was the independent predictor of EFT in post/late peri-menopausal women with OSA.

Highlights

Obstructive sleep apnea (OSA) is a sleep-related disorder with breathing difficulties
All the parameters in the sleep recordings including apnea–hypopnea index (AHI), mean oxygen saturation (Mean-Oxygen saturation (SaO2)), lowest nocturnal oxygen saturation (Lowest-SaO2), oxygen desaturation index (ODI), and percentage of total sleep time when blood oxygen saturation was less than 90% (T90), were measured by a skilled technician following American Academic Sleep Medicine (AASM) 2007 criteria
body mass index (BMI): Body mass index; Mean SaO2: mean oxygen saturation; Lowest SaO2: lowest oxygen saturation; T90: percentage of oxygen saturation less than 90%; ODI: oxygen desaturation index

Summary

Introduction

Obstructive sleep apnea (OSA) is a sleep-related disorder with breathing difficulties. The purpose of this study is to investigate the relationship between EFT and different clinical characteristics in pre- and post-menopausal women diagnosed with OSA. Obstructive sleep apnea (OSA) is a sleep-related disorder with breathing difficulties, which is characterized by repetitive collapse of upper respiratory tract during sleep [1]. These obstructive events lead to recurrent intermittent hypoxia and sleep disruption, which can result in cardiovascular and metabolism symptoms. A previous study showed that the odds ratios (ODs) for AHI ≥ 5/h in peri-menopausal, perimenopausal/post-menopausal, and post-menopausal (versus pre-menopausal) individuals were 1.23, 1.80 and 2.60, respectively [4], indicating a tendency of increasing apnea–hypopnea incidence with the progression of menopause. Visceral adipose tissue is an important predictor of metabolic heart disease, which seems to be a greater risk factor than general fat accumulation [6]

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