Quantitative CT analysis of intra-abdominal fat, subcutaneous fat, and bone mineral density disparities in individuals with obesity and obstructive sleep apnea compared to those with obesity alone

OBJECTIVE: This study aims to utilize quantitative computed tomography (QCT) to compare body composition parameters and bone mineral density (BMD) between two distinct patient groups: individuals with obesity and obstructive sleep apnea (OSA) and those with obesity alone (non-OSA group). By systematically evaluating QCT-derived metrics, we seek to identify specific imaging biomarkers that may aid in distinguishing OSA among obese individuals and to assess their potential diagnostic utility. METHODS: A total of 77 patients from Yan'an Hospital Affiliated with Kunming Medical University were enrolled and categorized into groups based on the presence of OSA. QCT was employed to collect data on fat-related and BMD parameters. The correlation between these parameters and OSA was analyzed, influencing factors were identified, and the diagnostic utility was assessed through receiver operating characteristic (ROC) curve analysis. RESULTS: The OSA group exhibited greater subcutaneous fat area, visceral fat area, total fat area, total fat at the inferior margin of L1-L4 vertebrae, visceral fat, subcutaneous fat weight, area, and volume compared to the non-OSA group. Additionally, the OSA group had a lower BMD at the L1 vertebra compared to the non-OSA group, and all of these differences were statistically significant (P < 0.05). ROC curve analysis indicated that the area under the ROC curve (AUC) for body weight and subcutaneous fat area at the inferior margin of L1 vertebra was 0.751 and 0.726, respectively. CONCLUSION: The QCT-derived measurements of intra-abdominal fat, subcutaneous fat, and BMD exhibit variations between patients with obesity and OSA compared to those with obesity alone. These differences serve as a potential foundation for identifying OSA in the obese demographic. Notably, the weight and subcutaneous fat area at the lower boundary of the L1 vertebra demonstrate enhanced diagnostic efficacy.