Xue Xu ¹ Jing Xu ^2* Mengye Zhang ^1*

• ¹ The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine）, Hangzhou, Jiangsu Province, China
• ² Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China

Background: Previous studies have established a connection between obesity and obstructive sleep apnea (OSA), novel surrogate markers of adipose accumulation may serve as more critical and reliable factors for consideration. Consequently, this study aims to explore and elucidate the correlation between metabolic score for visceral fat (METS-VF) and OSA.In this cross-sectional study, the data from the National Health and Nutrition Examination Survey (NHANES) during the period from 2013 to 2020 were adopted. Through multivariate logistic regression, restricted cubic spline regression (RCS), subgroup analyses and sensitivity analyses, the correlation between METS-VF and OSA was explored.Results: Among 8284 subjects, 4176 of them were categorized as having OSA. It was observed that the quartile range of METS-VF increased, with a notable rise in the prevalence of OSA (32.8% vs.49.8% vs. 56.9% vs. 62.1%, p<0.001). Logistic regression analyses showed a significant positive correlation between METS-VF and the risk of having OSA, even after accounting for potential confounders (OR=2.436, 95% CI: 2.065, 2.874). Subgroup analyses further revealed a stronger correlation between OSA and METS-VF among subjects who were female, younger, and Mexican Americans. RCS regression identified a positive linear correlation, without threshold effects.Sensitivity analyses with stop breathing (OR=2.283, 95%CI:1.169, 3.070) or snoring (OR=2.716, 95%CI:2.273, 3.246) as outcomes reaffirmed the positive correlation with METS-VF.Elevated METS-VF demonstrated a linear correlation with the increased incidence of OSA, suggesting the potential utility as a predictive index for OSA.