Abstract
ObjectiveChronic low-grade inflammation and adipokines dysregulation are linked to mechanisms underscoring the pathogenesis of obesity-related metabolic disorders. Little is known about roles of these cytokines on the association between snoring and metabolic syndrome (MetS). We aimed to investigate whether a cluster of cytokines are related to snoring frequency and its association with MetS in apparently healthy Chinese.MethodsCurrent analyses used a population-based sample including 1059 Shanghai residents aged 35–54 years. Self-reported snoring frequency was classified as never, occasionally and regularly. Fasting plasma glucose, lipid profile, insulin, C-reactive protein, interleukin-6, interleukin-18, lipopolysaccharide binding protein, high-molecular-weight adiponectin and leptin were measured. MetS was defined by the updated National Cholesterol Education Program Adult Treatment Panel III criteria for Asian-Americans.ResultsOverweight/obese subjects had significantly higher prevalence of regular snorers than their normal-weight counterparts (34.8% vs. 11.5%, P<0.001). Regular snoring was associated with unfavorable profile of inflammatory markers and adipokines. However, those associations were abolished after adjustment for body mass index (BMI) or waist circumference. The MetS risk (multivariate-adjusted odds ratio 5.41, 95% confidence interval 3.72–7.88) was substantially higher in regular snorers compared with non-snorers. Controlling for BMI remarkably attenuated the association (2.03, 1.26–3.26), while adjusting for inflammatory markers and adipokines showed little effects.ConclusionFrequent snoring was associated with an elevated MetS risk independent of lifestyle factors, adiposity, inflammatory markers and adipokines in apparently healthy Chinese. Whether snoring pattern is an economic and no-invasive indicator for screening high-risk persons needs to be addressed prospectively.
Highlights
Habitual snoring, a manifestation of sleep-disordered breathing (SDB), has been suggested to be associated with various cardiometabolic disorders, such as insulin resistance, hypertension, metabolic syndrome (MetS), type 2 diabetes, and cardiovascular diseases (CVD) by several epidemiological studies [1,2,3,4,5,6,7]
Circulating adiponectin was reported to be associated with frequent snoring among women with type 2 diabetes, which postulated a potential mechanism explaining the relationship between snoring and cardio-metabolic disorders [8]
High levels of Creactive protein (CRP), interleukin-18 (IL18), leptin and low adiponectin concentration were associated with higher MetS risk in our and other populations [18,19,20,21,22], it remains to be elucidated whether the association between snoring frequency and MetS is independent or mediated through traditional risk factors, and/or unfavorable profile of inflammatory and adipose cytokines
Summary
A manifestation of sleep-disordered breathing (SDB), has been suggested to be associated with various cardiometabolic disorders, such as insulin resistance, hypertension, metabolic syndrome (MetS), type 2 diabetes, and cardiovascular diseases (CVD) by several epidemiological studies [1,2,3,4,5,6,7]. Compared with Caucasians, Asian populations, including Chinese, tend to have higher abdominal and visceral adiposity at a given level of body mass index (BMI) [15], namely ‘metabolically obese’ phenomenon [16]. They are thought to have higher susceptibility for metabolic diseases like type 2 diabetes than Caucasians even with lower BMI [17]. High levels of CRP, interleukin-18 (IL18), leptin and low adiponectin concentration were associated with higher MetS risk in our and other populations [18,19,20,21,22], it remains to be elucidated whether the association between snoring frequency and MetS is independent or mediated through traditional risk factors, and/or unfavorable profile of inflammatory and adipose cytokines
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