Anna Zito

Obstructive sleep apnoea and metabolic syndrome in Mediterranean countries.

To the Editors: Obstructive sleep apnoea (OSA) is often associated with metabolic disturbances, including altered glucose metabolism and dyslipidaemia, which probably contribute to the increased cardiovascular risk in these patients 1. The concept of the metabolic syndrome (MetS) as a cluster of cardiometabolic risk factors has gained popularity in recent years, and a much higher prevalence of the MetS has been found in OSA patients compared with the general population in several studies 1. While the MetS largely reflects the effects of visceral obesity, environmental factors, i.e. the type of diet, could also play some role. The Mediterranean diet, rich in olive oil and fish, is protective against the MetS 2–4, but no study has examined the association of MetS and OSA in Mediterranean countries. We hypothesised that prevalence of the MetS might be lower in OSA patients living in the Mediterranean area compared with the prevalence values found in non-Mediterranean countries. Therefore, we retrospectively assessed the prevalence of the MetS according to the modified National Health and Nutrition Examination Survey Adult Treatment Panel (ATP) III criteria 5 in consecutive patients referred to sleep laboratories in Italy (n = 107), Spain (n = 138) and Greece (n = 218). Patients diagnosed with OSA in the period July 2007–September 2008 in Palermo, Italy (Respiratory Section, DIBIMIS, University of Palermo, and CNR Institute of Biomedicine and Molecular Immunology), Palma de Mallorca, Spain (Hospital Son Dureta) and Alexandroupolis, Greece (Sleep Unit, Medical School, Democritus University of Thrace), were evaluated in this study. All underwent …