Objective: This study aimed to evaluate the relationship between the cardiometabolic index (CMI) and obstructive sleep apnea (OSA) and to investigate its potential
clinical relevance in cardiovascular risk assessment.
Materials and Methods: A total of 158 patients who underwent polysomnography (PSG) with a preliminary diagnosis of sleep apnea between January 2022 and July
2023 were included. Demographic characteristics, anthropometric measurements, comorbidities, biochemical parameters, and CMI values were analyzed.
Results: Of the 158 patients, 112 (70.9%) were male. CMI values increased significantly with increasing OSA severity (p=0.03). A weak but statistically significant
positive correlation was found between the apnea–hypopnea index (AHI) and CMI (r=0.21, p<0.001, 95% CI: 0.001–0.020). An absolute difference of 0.88 units in
CMI was observed between patients with severe OSA and those with simple snoring. Although CMI values were higher in patients with cardiovascular disease, this
difference did not reach statistical significance (p = 0.385).
Conclusion: There is a significant positive association between OSA severity and CMI. CMI may serve as a simple and practical marker reflecting an adverse
cardiometabolic profile associated with cardiovascular risk in patients with OSA.
Cite this Article As :
Colak M, Coban H, Yumrukuz Senel M, Yilmaz G, Sarioglu N, Erel F. Association Between Obstructive Sleep Apnea Severity and Cardiometabolic Index
in the Context of Cardiovascular Risk. Selcuk Med J 2026;42(3): 241-246
1.Çolak M, Sarıoğlu N, Köse M, et al. Allergic rhinitis in the etiology of obstructive sleep apnea. ACAM. 2022;13(11):1252-56. doi:10.4328/ACAM.21280
2.Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle- aged adults. N Engl J Med 1993;328:1230-35. doi:10.1056/NEJM199304293281704
3.Partinen M, McNicholas T. Epidemiology, morbidity and mortality of the sleep apnoea syndrome. European Respiratory Monograph 1998;10:63-74
4. Turkish Thoracic Society. Obstructive Sleep Apnea Syndrome Diagnosis and Treatment Consensus Report 2012. Website: https://www.toraks.org.tr/site/community/downloads/4. Accessed May 11, 2026
5.Malow BA. Approach to the patient with disordered sleep In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 4th Ed. Philadelphia, WB Saunders, 2005;589-93. doi:10.1016/B0-72-160797-7/50055-0
6.Vaughn BV, D'Cruz OF. Cardinal manifestations of sleep disorders. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 4th Ed. Philadelphia, WB Saunders, 2005;594- 601. doi: 10.1016/b0-72-160797-7/50056-2
7.Çoşğun İG, Gürel A. Obstructive sleep apnea and bladder pain syndrome/interstitial cystitis in women. Sleep Breath. 2024; 28(2): 999-03. doi: 10.1007/s11325-023-02967-1
8.Liu X, Ma Y, Ouyang R, et al. The relationship between inflammation and neurocognitive dysfunction in obstructive sleep apnea syndrome. J Neuroinflammation. 2020;17(1):229. doi: 10.1186/s12974-020-01905-2
9.Mitra AK, Bhuiyan AR, Jones EA. Association and Risk Factors for Obstructive Sleep Apnea and Cardiovascular Diseases: A Systematic Review. Diseases. 2021;9(4):88. doi:10.3390/diseases9040088
10.Javaheri S, Barbe F, Campos-Rodriguez F, et al. Sleep Apnea: Types, Mechanisms, and Clinical Cardiovascular Consequences. J Am Coll Cardiol. 2017;69(7):841-58. doi: 10.1016/j.jacc.2016.11.069
11.Wakabayashi I, Sotoda Y, Hirooka S, et al. Association between cardiometabolic index and atherosclerotic progression in patients with peripheral arterial disease. Clin Chim Acta. 2015;446:231- 36. doi: 10.1016/j.cca.2015.04.020
12.Cai X, Hu J, Wen W, et al. Associations of the Cardiometabolic Index with the Risk of Cardiovascular Disease in Patients with Hypertension and Obstructive Sleep Apnea: Results of a Longitudinal Cohort Study. Oxid Med Cell Longev. 2022;23:4914791. doi: 10.1155/2022/4914791
13.Drager LF, Togeiro SM, Polotsky VY, et al. Obstructive sleep apnea: a cardiometabolic risk in obesity and the metabolic syndrome. J Am Coll Cardiol. 2013;62(7):569-76. doi: 10.1016/j.jacc.2013.05.045
14.Xu H, Xia Y, Li X, et al. Association between obstructive sleep apnea and lipid metabolism during REM and NREM sleep. J Clin Sleep Med. 2020;16(4):475-82. doi: 10.5664/jcsm.8242
15.Patil SP, Ayappa IA, Caples SM, et al. Treatment of adult obstructive sleep apnea with positive airway pressure: An American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2019;15(2):335-343. doi: 10.5664/jcsm.7638
16.Young T, Skatrud J, Peppard PE. Risk factors for obstructive sleep apnea in adults. JAMA. 2004;291(16):2013-16. doi: 10.1001/jama.291.16.2013
17.Tufik S, Santos-Silva R, Taddei JA, et al. Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Med. 2010;11(5):441-46. doi: 10.1016/j.sleep.2009.10.005
18.Schwartz AR, Patil SP, Laffan AM, et al. Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches. Proc Am Thorac Soc. 2008;5(2):185-92. doi: 10.1513/pats.200708-137MG
19.Wakabayashi I, Daimon T. The "cardiometabolic index" as a new marker determined by adiposity and blood lipids for discrimination of diabetes mellitus. Clin Chim Acta. 2015;438:274-8. doi: 10.1016/j.cca.2014.08.042
20.Shi WR, Wang HY, Chen S, et al. Estimate of prevalent diabetes from cardiometabolic index in general Chinese population: a community-based study. Lipids Health Dis. 2018;17(1):236. doi: 10.1186/s12944-018-0886-2.
21.Wang H, Chen Y, Guo X, et al. Usefulness of cardiometabolic index for the estimation of ischemic stroke risk among general population in rural China. Postgrad Med. 2017;129(8):834-841. doi: 10.1080/00325481.2017.1375714.