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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(10): 891-897
DOI: 10.1055/s-0043-1776411
Original Article

Triglyceride-glucose index as a predictor of obstructive sleep apnoea severity in the absence of traditional risk factors

Índice de triglicerídeos-glicose como preditor de gravidade da apneia obstrutiva do sono na ausência de fatores de risco tradicionais
Sinem Nedime Sökücü 
1   University of Health Sciences, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Sleep Laboratory, Istanbul, Turkey.
,
Şenay Aydın 
1   University of Health Sciences, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Sleep Laboratory, Istanbul, Turkey.
,
Celal Satıcı 
1   University of Health Sciences, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Sleep Laboratory, Istanbul, Turkey.
,
Seda Tural Önür 
1   University of Health Sciences, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Sleep Laboratory, Istanbul, Turkey.
,
Cengiz Özdemir 
2   Liv Hospital, Vadi Istanbul, Istanbul, Turkey.
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Abstract

Objective We evaluated the association between the triglyceride–glucose (TG) index, a marker of insulin resistance, and obstructive sleep apnoea (OSA) severity in patients without diabetes mellitus, obesity, and metabolic syndrome.

Methods This retrospective cohort study included 1,527 patients. We used univariate and multivariate analyses to identify the independent predictors associated with OSA.

Results Most patients were males (81.5%) with a mean age of 43.9 ± 11.1 (15–90) years. Based on the apnoea–hypopnea index (AHI), 353 (23.1%) patients were included in the control group, whereas 32.4%, 23.5%, and 21% had mild, moderate, and severe OSA, respectively. The TG index values demonstrated significant associations with OSA patients compared with the control group (p = 0.001). In addition, the mean values of the oxygen desaturation index (ODI), AHI, minimum oxygen saturation, and total sleep time percentage with saturation below 90% demonstrated statistically significant differences among the TG index groups (p: 0.001; p:0.001; p:0.001; p:0.003). The optimal TG index cutoff value to predict OSA was 8.615 (AUC = 0.638, 95% CI = 0.606–0.671, p = 0.001). In multivariate logistic regression analysis, after adjusting for age, sex, and body mass index, the TG index was independently associated with OSA patients.

Conclusion The TG index is independently associated with increased risk for OSA. This indicates that this index, a marker for disease severity, can be used to identify severe OSA patients on waiting lists for PSG.

Resumo

Objetivo Avaliamos a associação entre o índice triglicerídeos-glicose (TG), um marcador de resistência à insulina, e a gravidade da apneia obstrutiva do sono (AOS) em pacientes sem diabetes mellitus, obesidade e síndrome metabólica.

Métodos Este estudo de coorte retrospectivo incluiu 1.527 pacientes. Utilizamos análises univariadas e multivariadas para identificar os preditores independentes associados à AOS.

Resultados A maioria dos pacientes era do sexo masculino (81,5%) com idade média de 43,9 ± 11,1 anos (15-90). Com base no índice apneia-hipopneia (IAH), 353 (23,1%) pacientes foram incluídos no grupo de controle, enquanto 32,4%, 23,5% e 21% tinham AOS leve, moderada e grave, respectivamente. Os valores do índice TG demonstraram associações significativas com pacientes com AOS em comparação com o grupo de controle (p = 0,001). Além disso, os valores médios do índice de dessaturação de oxigênio (IDO), IAH, saturação mínima de oxigênio e porcentagem de tempo total de sono com saturação abaixo de 90% demonstraram diferenças estatisticamente significativas entre os grupos de índice TG (p = 0,001; p = 0,001; p = 0,001; p = 0,003). O valor de corte ideal do índice TG para prever a AOS foi de 8,615 (AUC=0,638, IC de 95% = 0,606–0,671, p = 0,001). Na análise de regressão logística multivariada, após o ajuste para idade, sexo e índice de massa corporal, o índice TG foi independentemente associado a pacientes com AOS.

Conclusão O índice TG está independentemente associado a um maior risco de AOS. Isso indica que este índice, um marcador de gravidade da doença, pode ser usado para identificar pacientes com AOS grave em listas de espera para polissonografia.

Keywords

Sleep Apnea, Obstructive - Prognosis - Triglyceride Glucose Index

Palavras-chave

Apneia Obstrutiva do Sono - Prognóstico - Índice Triglicerídeos e Glicose

Authors' Contributions

SNS: investigation, methodology, writing – original draft, writing – review & editing; SA: investigation, methodology, software, writing – original draft, writing – review & editing; CS: methodology, software, writing – review & editing; STO: software, writing – review & editing; CO: investigation, writing – review & editing.




Publication History

Received: 22 November 2022

Accepted: 24 June 2023

Article published online:
08 November 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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