{
  "abstract": "This cross-sectional study analyzed data from 9068 U.S. adults (weighted n = 170.2 million) in the 2015–2020 NHANES. It aimed to elucidate the nonlinear relationships between six anthropometric indices – Relative Fat Mass Index (RFM), Body Roundness Index (BRI), Weight-adjusted Waist Index (WWI), Body Mass Index (BMI), and waist circumference – and obstructive sleep apnea (OSA) risk. Furthermore, we pioneered an exploration of the potential mediating role of high-density lipoprotein cholesterol (HDL-C). Multivariable logistic regression, adjusted for sociodemographic, behavioral, and clinical confounders, revealed significant positive trends between all indices and OSA risk (P for trend < .05). Threshold effect models and smooth curve fitting identified distinct association patterns. RFM exhibited a linear dose-response relationship with OSA (P < .05), whereas BRI, WWI, BMI, and waist circumference demonstrated nonlinear positive correlations with identifiable inflection points (P < .05). Bootstrap mediation analysis (1000 replications) yielded results consistent with a significant mediating role for HDL-C, which explained 5.6 to 21.9% of the observed associations. This effect was most pronounced for WWI (13.2%). Stratified analyses indicated enhanced associations in participants aged < 60 years (interaction P < .05). These findings establish RFM as a linear predictor of OSA, contrasting with the nonlinear dynamics of other adiposity indices. The partial mediation by HDL-C underscores dysregulated lipid metabolism as a key pathological mechanism linking obesity to OSA, supporting the integration of anthropometric screening with lipid profiling to optimize clinical risk stratification and early intervention strategies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Geriatric Respiratory Medicine, Hebei General Hospital, Shijiazhuang, People’s Republic of China",
    "The Second People’s Hospital of Xinxiang, Xinxiang, People’s Republic of China",
    "Clinical Medical College, Jining Medical University, Jining, People’s Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Sheng Yue Jiang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xue Lian Du"
    },
    {
      "affs": [
        0
      ],
      "name": "Zi Qian Luo"
    },
    {
      "affs": [
        0
      ],
      "name": "Ping Ping Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Ya Qi Liang"
    },
    {
      "affs": [
        2
      ],
      "name": "Pang Pang Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Fen Ping"
    },
    {
      "affs": [
        0
      ],
      "name": "Ping Li",
      "orcid": "0009-0003-9707-3344"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a1pg93a7w2tv8.bib",
  "cited_by": 0,
  "doi": "10.1097/md.0000000000051275",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727269/?tool=EBI",
  "id": "a1pg93a7w2tv8",
  "issns": [
    "0304-5412",
    "1536-5964",
    "0025-7974"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13727269",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "6700"
    ],
    [
      "heading",
      "Observational Study"
    ],
    [
      "heading",
      "Research Article"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727269/pdf/?tool=EBI",
  "pmcid": "PMC13727269",
  "pmid": null,
  "published": "2026-10-30",
  "publisher": "Wolters Kluwer Health",
  "ris": "https://research.draconitic.com/paper/a1pg93a7w2tv8.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:51Z",
      "native_id": "PMC:PMC13727269",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727269"
    },
    {
      "first_seen": "2026-11-05T12:23:23Z",
      "native_id": "PMC13727269",
      "source": "pmc",
      "url": "https://doi.org/10.1097/md.0000000000051275"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Anthropometric indicators and risk of obstructive sleep apnea : Role of HDL-C as a potential mediator",
  "title_text": "Anthropometric indicators and risk of obstructive sleep apnea : Role of HDL-C as a potential mediator",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:22:59Z",
  "url": "https://research.draconitic.com/paper/a1pg93a7w2tv8",
  "venue": "Medicine",
  "versions": []
}