# The Role of Central Adiposity in the Link Between Obstructive Sleep Apnea and Frailty: Insights From NHANES 2015-2018

## TL;DR

This study explores how belly fat affects the link between sleep apnea and frailty, finding that higher belly fat increases the risk, especially in non-Hispanic White individuals.

## Contribution

The study reveals that central adiposity amplifies the association between obstructive sleep apnea and frailty, with racial differences observed in non-Hispanic White individuals.

## Key findings

- Individuals with obstructive sleep apnea and higher central adiposity had a significantly increased likelihood of frailty.
- Non-Hispanic White participants showed a stronger OSA-frailty association in the intermediate ABSI group compared to other racial/ethnic groups.

## Abstract

We investigated how body fat distribution, specifically central adiposity measured by the A Body Shape Index (ABSI), modifies the association between obstructive sleep apnea (OSA) and frailty and explored racial /ethnic differences, particularly focus on non-Hispanic White individuals. We used data from 4,154 adults in the NHANES 2015–2018. Frailty was measured using the 36-item Frailty Index. We applied logistic regression models to investigate the association between OSA and frailty, grouping participants into three levels (tertiles) based on their ABSI scores, with particular focus on the role of non-Hispanic White individuals. Among the 4,154 participants, 2,376 (57.2%) had OSA, and 469 (19.7%) were classified as frail. Individuals with OSA had a 1.5 times higher likelihood of frailty (P < 0.001). However, this association varied based on central adiposity levels. In participants with the lowest ABSI, no significant relationship was found between OSA and frailty. In contrast, the association was significant among those with moderate (OR = 1.564, 95% CI: 1.062–2.303, P = 0.049) and high (OR = 1.681, 95% CI: 1.105–2.556, P = 0.038) ABSI levels, indicating that greater central adiposity amplifies the OSA-frailty link. Racial differences were also evident. Non-Hispanic White participants exhibited a stronger association between OSA and frailty (OR = 1.829, 95% CI: 1.148–2.914, P = 0.009) compared to other racial/ethnic groups in the intermediate ABSI group. These findings emphasize the role of central adiposity in frailty risk among individuals with obstructive sleep apnea and underscore the need for race/ethnicity-specific risk assessments.