{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T04:47:18Z","timestamp":1782103638346,"version":"3.54.5"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003945","name":"Link\u00f6ping University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003945","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Obstructive Sleep Apnea (OSA) affects 1\u00a0billion people globally, with a male-to-female ratio of 2:1. While obesity is a major risk factor, sex differences in fat distribution may influence OSA risk. This study examined the relationship between visceral (VAT), subcutaneous (ASAT), and total abdominal fat (TAAT) and OSA severity in patients with type 2 diabetes (T2DM). We enrolled 164 T2DM patients (97 males, 67 females) from the EPSONIP-Sleep study; 151 had complete MRI and polygraphy data. OSA severity was evaluated by home respiratory polygraphy. Linear regression assessed AHI, logistic regression assessed moderate-to-severe OSA, and the Kruskal\u2013Wallis test compared AHI across VAT-z\/ASAT-z strata. In males, VAT, ASAT, and TAAT were associated with AHI in unadjusted analyses (\u03b2\u2009=\u20091.3,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.009; \u03b2\u2009=\u20091.5,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.010; \u03b2\u2009=\u20090.85,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.009, respectively). ASAT (OR\u2009=\u20091.23\/L, 95% CI 1.01\u20131.49,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.049) and TAAT (OR\u2009=\u20091.10\/L, 95% CI 1.00\u20131.22,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02), but not VAT, were associated with moderate-to-severe OSA. No statistically significant associations were detected in females. Associations were attenuated after BMI adjustment. AHI did not differ across VAT-z\/ASAT-z strata (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.430). Sex differences influenced the relationship between fat and OSA severity. In males, abdominal fat volumes were associated with higher OSA severity in unadjusted analyses, but not after BMI adjustment. No statistically significant associations were detected in females. These findings should be interpreted cautiously given the modest sample size.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-58058-0","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T03:36:06Z","timestamp":1782099366000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between fat distribution and obstructive sleep apnea severity among individuals with type 2 diabetes: an MRI-based study"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3776-6071","authenticated-orcid":false,"given":"Kim","family":"Ahtola","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Ulander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2041-943X","authenticated-orcid":false,"given":"Jonas","family":"Agholme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farida","family":"Amiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2482-7048","authenticated-orcid":false,"given":"Pontus","family":"Henriksson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olof Dahlqvist","family":"Leinhard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8661-2232","authenticated-orcid":false,"given":"Peter","family":"Lundberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Dahlstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl-Johan","family":"Carlh\u00e4ll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stergios","family":"Kechagias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrik","family":"Nasr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Forsgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5590-8601","authenticated-orcid":false,"given":"Mattias","family":"Ekstedt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4245-7565","authenticated-orcid":false,"given":"Fredrik","family":"Iredahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"58058_CR1","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.smrv.2016.07.002","volume":"34","author":"CV Senaratna","year":"2017","unstructured":"Senaratna, C. V. et al. Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep. Med. Rev. 34, 70\u201381 (2017).","journal-title":"Sleep. Med. Rev."},{"issue":"8","key":"58058_CR2","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","volume":"7","author":"AV Benjafield","year":"2019","unstructured":"Benjafield, A. V. et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 7 (8), 687\u2013698 (2019).","journal-title":"Lancet Respir Med."},{"issue":"7","key":"58058_CR3","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1164\/rccm.201806-1109TR","volume":"199","author":"OA Mesarwi","year":"2019","unstructured":"Mesarwi, O. A., Loomba, R. & Malhotra, A. Obstructive Sleep Apnea, Hypoxia, and Nonalcoholic Fatty Liver Disease. Am. J. Respir Crit. Care Med. 199 (7), 830\u2013841 (2019).","journal-title":"Am. J. Respir Crit. Care Med."},{"key":"58058_CR4","doi-asserted-by":"publisher","first-page":"983814","DOI":"10.1155\/2012\/983814","volume":"2012","author":"M Snel","year":"2012","unstructured":"Snel, M. et al. Ectopic fat and insulin resistance: pathophysiology and effect of diet and lifestyle interventions. Int. J. Endocrinol. 2012, 983814 (2012).","journal-title":"Int. J. Endocrinol."},{"issue":"10","key":"58058_CR5","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1111\/j.1524-6175.2006.888139.x","volume":"8","author":"LM Prisant","year":"2006","unstructured":"Prisant, L. M., Dillard, T. A. & Blanchard, A. R. Obstructive sleep apnea syndrome. J. Clin. Hypertens. (Greenwich). 8 (10), 746\u2013750 (2006).","journal-title":"J. Clin. Hypertens. (Greenwich)"},{"issue":"8","key":"58058_CR6","first-page":"1311","volume":"7","author":"KA Franklin","year":"2015","unstructured":"Franklin, K. A. & Lindberg, E. Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J. Thorac. Dis. 7 (8), 1311\u20131322 (2015).","journal-title":"J. Thorac. Dis."},{"issue":"12","key":"58058_CR7","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1093\/sleep\/32.12.1579","volume":"32","author":"DL Stadler","year":"2009","unstructured":"Stadler, D. L. et al. Abdominal compression increases upper airway collapsibility during sleep in obese male obstructive sleep apnea patients. Sleep 32 (12), 1579\u20131587 (2009).","journal-title":"Sleep"},{"issue":"1","key":"58058_CR8","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1111\/j.1440-1843.2011.02093.x","volume":"17","author":"S Isono","year":"2012","unstructured":"Isono, S. Obesity and obstructive sleep apnoea: mechanisms for increased collapsibility of the passive pharyngeal airway. Respirology 17 (1), 32\u201342 (2012).","journal-title":"Respirology"},{"issue":"1","key":"58058_CR9","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1152\/physrev.00033.2011","volume":"93","author":"A Tchernof","year":"2013","unstructured":"Tchernof, A. & Despr\u00e9s, J. P. Pathophysiology of Human Visceral Obesity: An Update. Physiol. Rev. 93 (1), 359\u2013404 (2013).","journal-title":"Physiol. Rev."},{"issue":"5","key":"58058_CR10","doi-asserted-by":"publisher","first-page":"1790","DOI":"10.1172\/JCI81507","volume":"125","author":"U Smith","year":"2015","unstructured":"Smith, U. Abdominal obesity: a marker of ectopic fat accumulation. J. Clin. Invest. 125 (5), 1790\u20131792 (2015).","journal-title":"J. Clin. Invest."},{"key":"58058_CR11","doi-asserted-by":"publisher","first-page":"111315","DOI":"10.1016\/j.biopha.2021.111315","volume":"137","author":"B Ahmed","year":"2021","unstructured":"Ahmed, B., Sultana, R. & Greene, M. W. Adipose tissue and insulin resistance in obese. Biomed. Pharmacother. 137, 111315 (2021).","journal-title":"Biomed. Pharmacother."},{"issue":"3","key":"58058_CR12","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1159\/000471488","volume":"10","author":"GH Goossens","year":"2017","unstructured":"Goossens, G. H. The Metabolic Phenotype in Obesity: Fat Mass, Body Fat Distribution, and Adipose Tissue Function. Obes. Facts. 10 (3), 207\u2013215 (2017).","journal-title":"Obes. Facts"},{"issue":"3","key":"58058_CR13","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1513\/AnnalsATS.201306-182OC","volume":"11","author":"Y Harada","year":"2014","unstructured":"Harada, Y. et al. Differences in Associations between Visceral Fat Accumulation and Obstructive Sleep Apnea by Sex. Annals Am. Thorac. Soc. 11 (3), 383\u2013391 (2014).","journal-title":"Annals Am. Thorac. Soc."},{"issue":"5","key":"58058_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/jim-2018-000722","volume":"66","author":"M Borga","year":"2018","unstructured":"Borga, M. et al. Advanced body composition assessment: from body mass index to body composition profiling. J. Investig Med. 66 (5), 1\u20139 (2018).","journal-title":"J. Investig Med."},{"issue":"2","key":"58058_CR15","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.mayocp.2021.08.021","volume":"97","author":"S Tejani","year":"2022","unstructured":"Tejani, S. et al. Cardiometabolic Health Outcomes Associated With Discordant Visceral and Liver Fat Phenotypes: Insights From the Dallas Heart Study and UK Biobank. Mayo Clin. Proc. 97 (2), 225\u2013237 (2022).","journal-title":"Mayo Clin. Proc."},{"issue":"11","key":"58058_CR16","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1002\/oby.22210","volume":"26","author":"J Linge","year":"2018","unstructured":"Linge, J. et al. Body Composition Profiling in the UK Biobank Imaging Study. Obes. (Silver Spring). 26 (11), 1785\u20131795 (2018).","journal-title":"Obes. (Silver Spring)"},{"issue":"3","key":"58058_CR17","doi-asserted-by":"publisher","first-page":"1702421","DOI":"10.1183\/13993003.02421-2017","volume":"51","author":"T Huang","year":"2018","unstructured":"Huang, T. et al. Sex differences in the associations of obstructive sleep apnoea with epidemiological factors. Eur. Respir. J. 51 (3), 1702421 (2018).","journal-title":"Eur. Respir. J."},{"issue":"1","key":"58058_CR18","doi-asserted-by":"publisher","first-page":"1835","DOI":"10.1186\/s12889-023-16695-4","volume":"23","author":"H Deng","year":"2023","unstructured":"Deng, H. et al. Association of adiposity with risk of obstructive sleep apnea: a population-based study. BMC Public. Health. 23 (1), 1835 (2023).","journal-title":"BMC Public. Health"},{"issue":"1","key":"58058_CR19","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1186\/s12876-021-01763-z","volume":"21","author":"P Nasr","year":"2021","unstructured":"Nasr, P. et al. Evaluating the prevalence and severity of NAFLD in primary care: the EPSONIP study protocol. BMC Gastroenterol. 21 (1), 180 (2021).","journal-title":"BMC Gastroenterol."},{"issue":"5","key":"58058_CR20","doi-asserted-by":"publisher","first-page":"675","DOI":"10.5664\/jcsm.6582","volume":"13","author":"L Xu","year":"2017","unstructured":"Xu, L. et al. Validation of the Nox-T3 Portable Monitor for Diagnosis of Obstructive Sleep Apnea in Chinese Adults. J. Clin. Sleep. Med. 13 (5), 675\u2013683 (2017).","journal-title":"J. Clin. Sleep. Med."},{"key":"58058_CR21","unstructured":"Hedner J. et al. Riktlinjer f\u00f6r utredning av misst\u00e4nkt s\u00f6mnapn\u00e9 hos vuxna 1\u201339 (Nationellt Kvalitetsregister SESAR\/Registercentrum V\u00e4st, 2018)."},{"key":"58058_CR22","doi-asserted-by":"crossref","unstructured":"Linge, J. et al. Skewness in Body fat Distribution Pattern Links to Specific Cardiometabolic Disease Risk Profiles (The Journal of Clinical Endocrinology & Metabolism, 2023).","DOI":"10.1210\/clinem\/dgad570"},{"issue":"3","key":"58058_CR23","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/S2213-8587(24)00316-4","volume":"13","author":"F Rubino","year":"2025","unstructured":"Rubino, F. et al. Definition and diagnostic criteria of clinical obesity. Lancet Diabetes Endocrinol. 13 (3), 221\u2013262 (2025).","journal-title":"Lancet Diabetes Endocrinol."},{"issue":"4","key":"58058_CR24","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1093\/sleep\/33.4.467","volume":"33","author":"L Simpson","year":"2010","unstructured":"Simpson, L. et al. Sex Differences in the Association of Regional Fat Distribution with the Severity of Obstructive Sleep Apnea. Sleep 33 (4), 467\u2013474 (2010).","journal-title":"Sleep"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-58058-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-58058-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-58058-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T03:50:38Z","timestamp":1782100238000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-58058-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["58058"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-58058-0","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]},"assertion":[{"value":"20 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"FI has received speaker fees and served on advisory boards for Novo Nordisk, Sanofi, and Boehringer Ingelheim. PN has received consulting fees from Boehringer Ingelheim. MF is an employee and shareholder of AMRA Medical AB. ODL is an employee, shareholder, and board member of AMRA Medical AB. PL is a shareholder of AMRA Medical AB. JA has re-ceived speaker fees from AstraZeneca. All other authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"19329"}}