Skip to main content
Top
Published in: BMC Women's Health 1/2021

Open Access 01-12-2021 | Sleep Apnea | Research

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

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

Published in: BMC Women's Health | Issue 1/2021

Login to get access

Abstract

Background

Obstructive 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.

Methods

Patients 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.

Results

A 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.

Conclusion

EFT 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.
Literature
1.
go back to reference Douglas NJ, Polo O. Pathogenesis of obstructive sleep apnoea/hypopnoea syndrome. Lancet. 1994;344(8923):653–5.CrossRef Douglas NJ, Polo O. Pathogenesis of obstructive sleep apnoea/hypopnoea syndrome. Lancet. 1994;344(8923):653–5.CrossRef
2.
go back to reference Franklin KA, Lindberg E. Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis. 2015;7(8):1311–22.PubMedPubMedCentral Franklin KA, Lindberg E. Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis. 2015;7(8):1311–22.PubMedPubMedCentral
3.
go back to reference Heinzer R, et al. Impact of sex and menopausal status on the prevalence, clinical presentation, and comorbidities of sleep-disordered breathing. Sleep Med. 2018;51:29–36.CrossRef Heinzer R, et al. Impact of sex and menopausal status on the prevalence, clinical presentation, and comorbidities of sleep-disordered breathing. Sleep Med. 2018;51:29–36.CrossRef
4.
go back to reference Young T, et al. Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med. 2003;167(9):1181–5.CrossRef Young T, et al. Menopausal status and sleep-disordered breathing in the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med. 2003;167(9):1181–5.CrossRef
5.
go back to reference Abdulnour J, et al. The effect of the menopausal transition on body composition and cardiometabolic risk factors: a Montreal-Ottawa New Emerging Team group study. Menopause. 2012;19(7):760–7.CrossRef Abdulnour J, et al. The effect of the menopausal transition on body composition and cardiometabolic risk factors: a Montreal-Ottawa New Emerging Team group study. Menopause. 2012;19(7):760–7.CrossRef
6.
go back to reference Sengul C, Ozveren O. Epicardial adipose tissue: a review of physiology, pathophysiology, and clinical applications. Anadolu Kardiyol Derg. 2013;13(3):261–5.PubMed Sengul C, Ozveren O. Epicardial adipose tissue: a review of physiology, pathophysiology, and clinical applications. Anadolu Kardiyol Derg. 2013;13(3):261–5.PubMed
7.
go back to reference Mariani S, et al. Association of epicardial fat thickness with the severity of obstructive sleep apnea in obese patients. Int J Cardiol. 2013;167(5):2244–9.CrossRef Mariani S, et al. Association of epicardial fat thickness with the severity of obstructive sleep apnea in obese patients. Int J Cardiol. 2013;167(5):2244–9.CrossRef
8.
go back to reference Lubrano C, et al. Relationships between body fat distribution, epicardial fat and obstructive sleep apnea in obese patients with and without metabolic syndrome. PLoS One. 2012;7(10):e47059.CrossRef Lubrano C, et al. Relationships between body fat distribution, epicardial fat and obstructive sleep apnea in obese patients with and without metabolic syndrome. PLoS One. 2012;7(10):e47059.CrossRef
9.
go back to reference Akilli H, et al. Gender-related changes of the epicardial fat thickness and leptin in obstructive sleep apnea. Echocardiography. 2014;31(4):411–9.CrossRef Akilli H, et al. Gender-related changes of the epicardial fat thickness and leptin in obstructive sleep apnea. Echocardiography. 2014;31(4):411–9.CrossRef
10.
go back to reference Chinese Medical Doctor Association Professional Committee on Sleep Medical, Multidisciplinary diagnosis and treatment guidelines of obstructive sleep apnea in adults. Natl Med J China, 2018,98(24):1902–14. Chinese Medical Doctor Association Professional Committee on Sleep Medical, Multidisciplinary diagnosis and treatment guidelines of obstructive sleep apnea in adults. Natl Med J China, 2018,98(24):1902–14.
11.
go back to reference Wildman RP, et al. Associations of endogenous sex hormones with the vasculature in menopausal women: the Study of Women’s Health Across the Nation (SWAN). Menopause. 2008;15(3):414–21.CrossRef Wildman RP, et al. Associations of endogenous sex hormones with the vasculature in menopausal women: the Study of Women’s Health Across the Nation (SWAN). Menopause. 2008;15(3):414–21.CrossRef
12.
go back to reference Xu H, et al. Elevated low-density lipoprotein cholesterol is independently associated with obstructive sleep apnea: evidence from a large-scale cross-sectional study. Sleep Breath. 2016;20(2):627–34.CrossRef Xu H, et al. Elevated low-density lipoprotein cholesterol is independently associated with obstructive sleep apnea: evidence from a large-scale cross-sectional study. Sleep Breath. 2016;20(2):627–34.CrossRef
13.
go back to reference Polesel DN, et al. Waist circumference and postmenopause stages as the main associated factors for sleep apnea in women: a cross-sectional population-based study. Menopause. 2015;22(8):835–44.CrossRef Polesel DN, et al. Waist circumference and postmenopause stages as the main associated factors for sleep apnea in women: a cross-sectional population-based study. Menopause. 2015;22(8):835–44.CrossRef
14.
go back to reference Lang RM, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18(12):1440–63.CrossRef Lang RM, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18(12):1440–63.CrossRef
15.
go back to reference Iacobellis G, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res. 2003;11(2):304–10.CrossRef Iacobellis G, et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res. 2003;11(2):304–10.CrossRef
16.
go back to reference Derin S, et al. Association of epicardial fat thickness with clinical and polysomnographic parameters in non-obese obstructive sleep apnoea patients. J Laryngol Otol. 2018;132(5):439–45.CrossRef Derin S, et al. Association of epicardial fat thickness with clinical and polysomnographic parameters in non-obese obstructive sleep apnoea patients. J Laryngol Otol. 2018;132(5):439–45.CrossRef
17.
go back to reference El Khoudary SR, et al. Cardiovascular fat, menopause, and sex hormones in women: the SWAN cardiovascular fat ancillary study. J Clin Endocrinol Metab. 2015;100(9):3304–12.CrossRef El Khoudary SR, et al. Cardiovascular fat, menopause, and sex hormones in women: the SWAN cardiovascular fat ancillary study. J Clin Endocrinol Metab. 2015;100(9):3304–12.CrossRef
18.
go back to reference Akyildiz ZI, et al. Epicardial fat, body mass index, and triglyceride are independent contributors of serum fibroblast growth factor 21 level in obese premenopausal women. J Endocrinol Invest. 2015;38(3):361–6.CrossRef Akyildiz ZI, et al. Epicardial fat, body mass index, and triglyceride are independent contributors of serum fibroblast growth factor 21 level in obese premenopausal women. J Endocrinol Invest. 2015;38(3):361–6.CrossRef
19.
go back to reference Fernandez Munoz MJ, et al. Epicardial adipose tissue is associated with visceral fat, metabolic syndrome, and insulin resistance in menopausal women. Rev Esp Cardiol (Engl Ed). 2014;67(6):436–41.CrossRef Fernandez Munoz MJ, et al. Epicardial adipose tissue is associated with visceral fat, metabolic syndrome, and insulin resistance in menopausal women. Rev Esp Cardiol (Engl Ed). 2014;67(6):436–41.CrossRef
20.
go back to reference Tavares e Castro A, et al. Obstructive sleep apnea in women: Prevalence, risk factors and relation to menopausal status. Rev Port Pneumol. 2014;20(6):342–3.CrossRef Tavares e Castro A, et al. Obstructive sleep apnea in women: Prevalence, risk factors and relation to menopausal status. Rev Port Pneumol. 2014;20(6):342–3.CrossRef
21.
go back to reference Naufel MF, et al. Association between obesity and sleep disorders in postmenopausal women. Menopause. 2018;25(2):139–44.CrossRef Naufel MF, et al. Association between obesity and sleep disorders in postmenopausal women. Menopause. 2018;25(2):139–44.CrossRef
22.
go back to reference Li QY, et al. BMI is an independent risk factor for snoring in Chinese women aged over 30 years. Sleep Breath. 2009;13(3):289–93.CrossRef Li QY, et al. BMI is an independent risk factor for snoring in Chinese women aged over 30 years. Sleep Breath. 2009;13(3):289–93.CrossRef
23.
go back to reference Cetin S, et al. Epicardial fat thickness regression with continuous positive airway pressure therapy in patients with obstructive sleep apnea: assessment by two-dimensional echocardiography. Wien Klin Wochenschr. 2016;128(5–6):187–92.CrossRef Cetin S, et al. Epicardial fat thickness regression with continuous positive airway pressure therapy in patients with obstructive sleep apnea: assessment by two-dimensional echocardiography. Wien Klin Wochenschr. 2016;128(5–6):187–92.CrossRef
24.
go back to reference Perger E, Mattaliano P, Lombardi C. Menopause and sleep apnea. Maturitas. 2019;124:35–8.CrossRef Perger E, Mattaliano P, Lombardi C. Menopause and sleep apnea. Maturitas. 2019;124:35–8.CrossRef
Metadata
Title
Different clinical parameters inform epicardial fat thickness in pre- and post-menopausal women with obstructive sleep apnea
Authors
Yong Zhang
Jian Wang
Wen Shui
Zhenxia Zhang
Juan Li
Jin Ma
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Sleep Apnea
Published in
BMC Women's Health / Issue 1/2021
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-021-01384-4

Other articles of this Issue 1/2021

BMC Women's Health 1/2021 Go to the issue