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KMID : 1034320210120010050
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Sleep Medicine Research
2021 Volume.12 No. 1 p.50 ~ p.56
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The Influence of Obesity on the Association of Obstructive Sleep Apnea and Atrial Fibrillation
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Stafford Patrick L.
Harmon Evan K.
Patel Paras
Walker McCall
Lin Gen-Min
Park Seung-Jung
Chatterjee Neal A.
Mehta Nishaki K.
Mazimba Sula
Bilchick Kenneth
Kwon Young-Hoon
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Abstract
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Background and Objective: The association between obstructive sleep apnea (OSA) and atrial fibrillation (AF) has been closely studied. However, obesity is a powerful confounder in the causal relationship between OSA and cardiovascular disease. The contribution of obesity in the relationship between OSA and AF remains unclear.
Methods: We recruited 457 consecutive patients equally with and without AF who underwent clinically indicated diagnostic polysomnography at a single academic sleep center. Multivariable logistic regression adjusting for age, sex, hypertension, and heart failure was performed to study the independent association between OSA and AF stratified by obesity.
Results: A total of 457 patients (male: 56.2%, mean age 63.1 ± 13.3 years) was included. OSA prevalence was similar between those with and without AF (52.6% vs. 47.4%, respectively; p = 0.24). In multivariable analysis, no association was found between AF and OSA regardless of obesity status. When severe OSA (vs. non-severe OSA) was modeled as a dependent variable, AF was associated with a higher likelihood of severe OSA in non-obese patients [odds ratio (OR): 2.29, 95% confidence interval (CI): 1.23?4.35, p = 0.01], but not in obese patients (OR: 0.95, 95% CI: 0.48?1.90, p = 0.89).
Conclusions: The association of OSA with AF was present only in the non-obese and was limited to severe OSA patients. In contrast, no association was found in obese patients. The association between OSA and AF is partly dependent on the body habitus.
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KEYWORD
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Obesity, Obstructive sleep apnea, Atrial fibrillation
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