Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Mar 15, 2025; 16(3): 98519
Published online Mar 15, 2025. doi: 10.4239/wjd.v16.i3.98519
Cross-sectional study of the association between triglyceride glucose-body mass index and obstructive sleep apnea risk
Li Gong, Ming Su, Jing-Han Xu, Zhen-Fei Peng, Lin Du, Ze-Yao Chen, Yu-Zhou Liu, Lu-Cia Chan, Yin-Luan Huang, Yu-Tian Chen, Feng-Yi Huang, Chun-Li Piao
Li Gong, Zhen-Fei Peng, Yu-Zhou Liu, Yin-Luan Huang, Yu-Tian Chen, Feng-Yi Huang, Department of Diabetes, Shenzhen Bao'an Chinese Medicine Hospital Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
Ming Su, Department of Pneumology, Shenzhen Bao'an Chinese Medicine Hospital Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
Jing-Han Xu, Lin Du, Ze-Yao Chen, Lu-Cia Chan, Chun-Li Piao, Department of Endocrinology, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen 518100, Guangdong Province, China
Co-first authors: Li Gong and Ming Su.
Author contributions: Gong L, Su M, Xu JH, and Piao CL were responsible for designing the review protocol, writing the protocol and report, conducting the search, screening potentially eligible studies, extracting and analyzing the data, interpreting the results, updating the reference lists, and creating the “Summary of findings” tables; Peng ZF, Du L, and Chen ZY were responsible for designing the review protocol and screening potentially eligible studies, contributing to the writing of the report, extracting and analyzing the data, interpreting the results, and creating the “Summary of findings” tables; Gong L and Liu YZ conducted the meta-regression analyses and contributed to the design of the review protocol, the writing of the report, arbitrating potentially eligible studies, extracting and analyzing the data, and interpreting the results; Huang FY contributed to the data extraction and provided feedback on the report; Huang YL and Chen YT provided feedback on the report. Gong L and Su M contributed equally to this work as co-first authors.
Supported by Sanming Project of Medicine in Shenzhen, No. SZZYSM202202010.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Shenzhen Bao'an Chinese Medicine Hospital.
Informed consent statement: The National Health and Nutrition Examination Survey (NHANES) is a public database. All patients involved in the database have received ethical approval. Users can download relevant data for free to conduct research and publish relevant articles.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.
Data sharing statement: The original contributions presented in this study are included in the article and its Supplementary material. Further inquiries can be directed to the corresponding authors.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Li Piao, DPhil, Chief Doctor, Professor, Department of Endocrinology, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, No. 6001 Beihuan Avenue, Futian District, Shenzhen 518100, Guangdong Province, China. pcl2013@sina.cn
Received: June 28, 2024
Revised: September 10, 2024
Accepted: December 27, 2024
Published online: March 15, 2025
Processing time: 207 Days and 8.7 Hours
Abstract
BACKGROUND

The triglyceride glucose-body mass index (TyG-BMI) is a novel indicator of insulin resistance (IR). Obstructive sleep apnea (OSA) is a prevalent disorder characterized by recurrent complete or partial collapse of the pharyngeal airway during sleep; however, the relationship between these two conditions remains unexplored. We hypothesized that a higher TyG-BMI is associated with the occurrence of OSA.

AIM

To assess the association between TyG-BMI and OSA in adults in the United States.

METHODS

A cross-sectional study was conducted utilizing data from the National Health and Nutrition Examination Surveys spanning from 2005-2008 to 2015-2018. TyG-BMI was calculated as Ln [triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2] × BMI. Restricted cubic splines were used to analyze the risk of TyG-BMI and OSA occurrence. To identify potential nonlinear relationships, we combined Cox proportional hazard regression with smooth curve fitting. We also conducted sensitivity and subgroup analyses to verify the robustness of our findings.

RESULTS

We included 16794 participants in the final analysis. Multivariate regression analysis showed that participants with a higher TyG-BMI had a higher OSA incidence. After adjusting for all covariates, TyG-BMI was positively correlated with the prevalence of OSA (odds ratio: 1.28; 95% confidence interval: 1.17, 1.40; P < 0.001); no significant nonlinear relationship was observed. Subgroup analysis showed no strong correlation between TyG-BMI and OSA in patients with diabetes. The correlation between TyG-BMI and OSA was influenced by age, sex, smoking status, marital status, hypertensive stratification, and obesity; these subgroups played a moderating role between TyG-BMI and OSA. Even after adjusting for all covariates, there was a positive association between TYG-BMI and OSA prevalence.

CONCLUSION

A higher TyG-BMI index is linked to higher chances of developing OSA. As TyG-BMI is an indicator of IR, managing IR may help reduce the risk of OSA.

Keywords: Obstructive sleep apnea; Triglyceride glucose-body mass index; Insulin resistance; Cross-sectional; National Health and Nutrition Examination Surveys

Core Tip: This study confirmed a positive linear exponential risk relationship between triglyceride glucose-body mass index (TyG-BMI) and obstructive sleep apnea (OSA) in adults in the United States, underscoring the potential utility of TyG-BMI as an evaluation and monitoring tool for insulin resistance (IR) in patients with OSA. The results suggest that assessing IR through the TyG-BMI index may help in the clinical evaluation of patients with OSA, independently of other metabolic risk factors.