Clinical study of the association of metabolic syndrome and obstructive sleep apnea in older patients

BACKGROUND: The relevance of the topic stems from the high comorbidity of metabolic syndrome and obstructive sleep apnea (OSA) in the older population, which increases the risk of cardiovascular complications and leads to the formation of a vicious circle.

AIM: To study the interrelationship between the components of metabolic syndrome and moderate obstructive sleep apnea in older patients.

METHODS: The study included 132 older patients (67.1 ± 2.9 years). Depending on the presence of abdominal obesity (AO) and OSA, four groups were formed: group 1, AO−/OSA− (32 participants); group 2, AO−/OSA+ (30 participants); group 3, AO+/OSA− (34 participants); and group 4, AO+/OSA+ (36 participants).

RESULTS: The most pronounced worsening of the metabolic profile was observed in older patients with comorbidity of AO and OSA: progression of insulin resistance (by HOMA-IR), deterioration of integral metabolic status (pronounced increase in TyG), and enhancement of the atherogenic dyslipidemic profile (increased triglycerides / low-density lipoprotein cholesterol). The highest blood pressure values and the greatest prevalence of circadian rhythm disturbances were found in AO+/OSA+ patients, indicating a more severe course of hypertension in this group compared with the others. Correlation analysis confirmed the high diagnostic efficacy of the TyG index as a marker of metabolic disorders in elderly patients (ρ = 0.847, p < 0.001).

CONCLUSION: The presented data suggest that the highest risk of metabolic disorders and the most severe course of arterial hypertension were observed in patients with comorbidity of abdominal obesity and moderate obstructive sleep apnea. The TyG index has high diagnostic accuracy for metabolic disorders in older patients.