Snoring is associated with body composition in (peri-post)menopausal women [post]

2019 unpublished
Little attention has been paid to whether snoring frequency is associated with body composition in menopausal women, particularly in China. This study objected to investigate the association between self-reported snoring and body composition in (peri-post) menopausal Chinese women as well as glucose/lipid metabolic indicators. Methods: This cross-sectional study enrolled 715 participants aged 40-67 years from the Menopause Clinic in the Shanghai Sixth People's Hospital. Participants were
more » ... cipants were categorized into four subgroups stratified by self-reported snoring frequency: never, rarely (<1 night per week), occasionally (1-2 nights per week), regularly (≥3 nights per week), while body composition was measured using bioelectrical impedance analysis(BIA).Besides, blood sample were collected to test the glycolipid indicators. Results: In our sample of investigation, regular snoring (≥3 nights per week) was found to be an independent risk factor for higher fat mass (total, upper limbs, trunk), with the highest risk of 2.4 times for fat mass of trunk after adjusting for glucose/lipid metabolic confounders(p=0.003). Meanwhile, regular snoring was independently associated with higher fat mass (total and each segment) only in the menopausal transition (p=0.023). Conclusion: We suggested that self-reported regular snoring may be taken as a simple alternative to predict higher fat mass (≥17.11kg, upper quartile) in menopausal women. Similarly, body composition should be attached to the great importance to those who in menopausal transition in order to help to prevent obstructive sleep apnea(OSA). Background Snoring, the manifestation of increased upper airway resistance, is commonly regarded as a reliable proxy marker of obstructive sleep apnea(OSA) [1, 2].Moreover, regular snoring has been suggested to be correlated with obesity[3], hypertension[4] and diabetes mellitus [5]. Since OSA is supposed to be more prevalent in men than women, the gap was narrowed when women approach menopause [6, 7]. In addition, previous studies have reported that menopause was an important risk factor for snoring [8, 9]. Menopause is well documented as an essential physiological stage of women's lives with vasomotor 4 symptoms[10], sleep disorder[11] and etc. Meanwhile, menopause is a vital window for variations in the body composition and rising in the body weight caused by hormonal alterations [12] . However, body mass index, BMI, is not a valid measure of true obesity status in menopausal women [13] .Changes in menopause-related body composition may be covered and underestimated by stable BMI since the counteractive effect of loss of lean mass and gain of fat mass when aging. Therefore, body composition by bioelectrical impedance analysis (BIA) may be a more representative and precise instrument rather than BMI among menopausal Chinese women [14] . So far, current studies on the association of snoring and obesity have focused primarily on men and children [3, 15] ,while underrepresented women. In addition, any association between snoring and body composition in menopausal women has received little attention. Since it's possible that glycolipid metabolism may confound the association, and whether snoring is associated with body composition in menopausal women independently of glycolipid metabolism confounders remains unknown. Given the evidence of the cross interplay among snoring, obesity and menopause, we aim to explore the association with snoring and body composition in menopausal women. Subjects and methods Study participants This cross-sectional study enrolled participants who visited the Menopause Clinic in the Shanghai Sixth People's Hospital. Han-Chinese woman aged 40-67 years passing through the menopause were recruited. Exclusion criteria were (1) with rhinitis; (2) having severe internal illnesses and/or diseases such as myocardial infarction, stroke, and cancer; (3) current smoking (at least once per week for the previous 6 months); (4) excessive alcohol drinking (at least one pack per month for the previous 6 months); (5) suffering from thyroid disease; (6) having tubercle and cachexy; (7) missing data. Ultimately,715 participants were recruited in this study. All participants given the informed consent after full explanation, which was approved by the Institutional Review Board of Shanghai Sixth People's Hospital"2016-R07". General questionnaire Baseline sociodemographic information was collected from a questionnaire through face-to-face 5 interview, which has been previously employed [11] ; Variables included age, marital status, employment status, education level, income per month, menopausal age, menopausal status, history of chronic disease (i.e., hypertension, diabetes mellitus, rhinitis, other diseases), besides, lifestyle (i.e., smoke, alcohol consumption) were recorded. Guiding by the Stages of Reproductive Aging Workshop (STRAW +10) [16] ,participants were divided into three different menopausal subgroups, namely menopausal transition group (consecutive irregularities for over 7 days of menstrual cycle), early postmenopausal group (absence of menstrual periods for 12months -5 years) and late postmenopausal group (absence of menstrual periods for ≥ 5 years).Hypertension was defined by any prior diagnosis from the questionnaire or by the criteria recommended by the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) [17] . While diabetes mellitus was identified by FPG ≥ 7 mmol/L or received any treatment for diabetes according to the WHO criteria [18] . Snoring frequency assessment Participants were asked by the question to assess the sleep snoring frequency, which was applied previously [19, 20] . "Over the past 4 weeks, did you snore? And if did, how many times per week?" and the options for responses were "never", "rarely", "occasionally", and "regularly", corresponding to "never", " 1 night per week", "1-2 nights per week", and "≥ 3 nights per week", respectively. Anthropometric and lab tests We measured and recorded participants' weight, height. Body mass index (BMI) was computed by dividing weight in kilograms by the square of their height in meters. We took the blood pressure for all participants on the right arm three consecutive times after 5-minute sitting (systolic blood pressure(SBP), diastolic blood pressure(DBP)). Blood samples were collected for the detection of serum concentration of triglyceride(TG), cholesterol(TC), high-density lipoprotein (HDL), low-density lipoprotein(LDL), and fasting blood glucose(FBG) after an overnight fast. Body composition We measured the body composition by BIA (TBF-418B analyzer; TANITA) of lean mass (LM), fat mass (FM), and fat-free mass (FFM), and each segment included upper /lower limbs, and trunk. We
doi:10.21203/rs.2.12092/v1 fatcat:ybeylgtkrbd6pig7isam3kmvim