Qizheng Guo, Weihang Xu, Changcong Wang, Muchen Xie, Zhuoxin Wu, Ning Zhang, Baorui Zhang, Dongmei Mu
{"title":"相对脂肪量与阻塞性睡眠呼吸暂停的关系及高血压的潜在中介作用：基于NHANES 2005-2008和2015-2018。","authors":"Qizheng Guo, Weihang Xu, Changcong Wang, Muchen Xie, Zhuoxin Wu, Ning Zhang, Baorui Zhang, Dongmei Mu","doi":"10.1186/s12937-025-01205-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Obesity has been identified as one of the contributing factors to obstructive sleep apnea (OSA). The current obesity assessment indicators have poor ability to distinguish between fat and muscle. Relative fat mass (RFM) a new indicator of obesity that takes into account gender differences and can predict body fat conditions has advantage in this respect. This study aimed to investigate the potential association between RFM and OSA, as well as the possible mediating effect of hypertension.</p><p><strong>Methods: </strong>This cross-sectional study used data from the National Health and Nutrition Examination Survey conducted in 2005-2008 and 2015-2018. Multivariate logistic regression, restricted cubic splines (RCS), and subgroup analyses were performed to evaluate the association between RFM and OSA. In addition, the receiver operating characteristic curve (ROC) of different obesity indicators was compared to assess their predictive ability for OSA. Mediation analysis was used to explore the potential mediating role of hypertension in the positive correlation.</p><p><strong>Results: </strong>The study included 13,532 participants with complete study data, of which 6854 were assessed as having OSA according to the criteria, accounting for 50.65% of the study population. The results of the multivariate logistic regression model with fully adjusted covariates showed that the odds ratio of RFM was 1.096 (95%CI:1.084-1.109, P < 0.001). The results of the RCS show that RFM is nonlinearly correlated with OSA (P for nonlinear < 0.01). Subgroup analysis showed that the association between RFM and OSA was stronger in female and people younger than 60. The ROC also indicates that, compared with the body roundness index and weight-adjusted-waist index, RFM showed potential as a predictor. Mediation analysis and sensitivity analysis showed that hypertension had a statistically significant but poorly robust mediating effect between RFM and OSA.</p><p><strong>Conclusion: </strong>There is a positive and nonlinear correlation between RFM and OSA. Hypertension plays a potential mediating role in the positive association between RFM and OSA, but its robustness is poor. RFM shows potential as a predictor of OSA, but more prospective studies are needed to confirm these findings and determine the causal relationship between RFM and OSA.</p>","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":"24 1","pages":"141"},"PeriodicalIF":3.8000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465428/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association between relative fat mass and obstructive sleep apnea and the potential mediating effect of hypertension: based on NHANES 2005-2008 and 2015-2018.\",\"authors\":\"Qizheng Guo, Weihang Xu, Changcong Wang, Muchen Xie, Zhuoxin Wu, Ning Zhang, Baorui Zhang, Dongmei Mu\",\"doi\":\"10.1186/s12937-025-01205-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Obesity has been identified as one of the contributing factors to obstructive sleep apnea (OSA). The current obesity assessment indicators have poor ability to distinguish between fat and muscle. Relative fat mass (RFM) a new indicator of obesity that takes into account gender differences and can predict body fat conditions has advantage in this respect. This study aimed to investigate the potential association between RFM and OSA, as well as the possible mediating effect of hypertension.</p><p><strong>Methods: </strong>This cross-sectional study used data from the National Health and Nutrition Examination Survey conducted in 2005-2008 and 2015-2018. Multivariate logistic regression, restricted cubic splines (RCS), and subgroup analyses were performed to evaluate the association between RFM and OSA. In addition, the receiver operating characteristic curve (ROC) of different obesity indicators was compared to assess their predictive ability for OSA. Mediation analysis was used to explore the potential mediating role of hypertension in the positive correlation.</p><p><strong>Results: </strong>The study included 13,532 participants with complete study data, of which 6854 were assessed as having OSA according to the criteria, accounting for 50.65% of the study population. The results of the multivariate logistic regression model with fully adjusted covariates showed that the odds ratio of RFM was 1.096 (95%CI:1.084-1.109, P < 0.001). The results of the RCS show that RFM is nonlinearly correlated with OSA (P for nonlinear < 0.01). Subgroup analysis showed that the association between RFM and OSA was stronger in female and people younger than 60. The ROC also indicates that, compared with the body roundness index and weight-adjusted-waist index, RFM showed potential as a predictor. Mediation analysis and sensitivity analysis showed that hypertension had a statistically significant but poorly robust mediating effect between RFM and OSA.</p><p><strong>Conclusion: </strong>There is a positive and nonlinear correlation between RFM and OSA. Hypertension plays a potential mediating role in the positive association between RFM and OSA, but its robustness is poor. RFM shows potential as a predictor of OSA, but more prospective studies are needed to confirm these findings and determine the causal relationship between RFM and OSA.</p>\",\"PeriodicalId\":19203,\"journal\":{\"name\":\"Nutrition Journal\",\"volume\":\"24 1\",\"pages\":\"141\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-09-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465428/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nutrition Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12937-025-01205-6\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutrition Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12937-025-01205-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Association between relative fat mass and obstructive sleep apnea and the potential mediating effect of hypertension: based on NHANES 2005-2008 and 2015-2018.
Background: Obesity has been identified as one of the contributing factors to obstructive sleep apnea (OSA). The current obesity assessment indicators have poor ability to distinguish between fat and muscle. Relative fat mass (RFM) a new indicator of obesity that takes into account gender differences and can predict body fat conditions has advantage in this respect. This study aimed to investigate the potential association between RFM and OSA, as well as the possible mediating effect of hypertension.
Methods: This cross-sectional study used data from the National Health and Nutrition Examination Survey conducted in 2005-2008 and 2015-2018. Multivariate logistic regression, restricted cubic splines (RCS), and subgroup analyses were performed to evaluate the association between RFM and OSA. In addition, the receiver operating characteristic curve (ROC) of different obesity indicators was compared to assess their predictive ability for OSA. Mediation analysis was used to explore the potential mediating role of hypertension in the positive correlation.
Results: The study included 13,532 participants with complete study data, of which 6854 were assessed as having OSA according to the criteria, accounting for 50.65% of the study population. The results of the multivariate logistic regression model with fully adjusted covariates showed that the odds ratio of RFM was 1.096 (95%CI:1.084-1.109, P < 0.001). The results of the RCS show that RFM is nonlinearly correlated with OSA (P for nonlinear < 0.01). Subgroup analysis showed that the association between RFM and OSA was stronger in female and people younger than 60. The ROC also indicates that, compared with the body roundness index and weight-adjusted-waist index, RFM showed potential as a predictor. Mediation analysis and sensitivity analysis showed that hypertension had a statistically significant but poorly robust mediating effect between RFM and OSA.
Conclusion: There is a positive and nonlinear correlation between RFM and OSA. Hypertension plays a potential mediating role in the positive association between RFM and OSA, but its robustness is poor. RFM shows potential as a predictor of OSA, but more prospective studies are needed to confirm these findings and determine the causal relationship between RFM and OSA.
期刊介绍：
Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered.
Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies.
In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.
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