Body Muscle-to-Fat Ratio as a Sleep Apnea Screening Tool in Type 2 Diabetes

Body composition measures were examined as a screening tool to detect obstructive sleep apnea syndrome in patients with T2D.

The body muscle-to-fat ratio (BMFR) is a useful screening tool for evaluating obstructive sleep apnea syndrome (OSAS) in patients with uncontrolled type 2 diabetes (T2D), according to a study published in Diabetes Research and Clinical Practice.

The study included 186 individuals who were inpatients at Diabetes Care Center of Jinnouchi Hospital in Kumamoto, Japan between June 2015 and October 2017 and who had sleep disordered breathing in connection with previously diagnosed and poorly controlled T2D. 

Weight, body mass index, and BMFR were measured in all participants. BMFR for OSAS diagnoses was then evaluated using receiver operating characteristic curve analysis and the resulting area under the BMFR curve was 0.70 (P <.001). The result showed that BMFR is useful and prognostic in diagnosing OSAS. The diagnoses of OSAS relied partially on the rest disturbances index as opposed to polysomnography. 

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Weight, body mass index, waist circumferences, total body fat mass, body fat percentage, BMFR, hypertension, and eGFR were significantly associated with OSAS.  In addition, BMFR was significantly and independently associated with OSAS (odds ratio 0.54; 95% CI, 0.34-0.85; P <.01).   In participants with a relatively low body mass index, BMFR was also predictive of OSAS in patients with T2D (P =.002).

The researchers conclude that, “in patients with T2DM, the BMFR may be useful as a screening marker for OSAS in daily clinical practice.”


Kurinami N, Sugiyama S, Ijima H, et el. Clinical usefulness of the body muscle-to-fat ratio for screening obstructive sleep apnea syndrome in patients with inadequately controlled type 2 diabetes mellitus. Diabetes Res Clin Pract. 2018; 143:134-139.