{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T12:01:24Z","timestamp":1776859284923,"version":"3.51.2"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Obstructive sleep apnea (OSA) predominantly affects patients who are obese and causes systemic organ damage. Little is known about the relationship between fat distribution and bone impairment in these patients. We aimed to evaluate the impact of the visceral adipose tissue (VAT) on the bone quality of patients with OSA. In our prospective study, 49 untreated patients with mild\u2010to\u2010severe OSA underwent dual\u2010energy X\u2010ray absorptiometry. Polygraphy data were also collected. According to the recent reference values for European adults, patients were divided by the sex\u2010related threshold of the VAT index into two categories: VAT index within limits (normal VAT [nVAT]) and increased VAT (iVAT). In all, 63% of the patients were in the iVAT category. Compared to patients with nVAT, those with iVAT had a higher prevalence of arterial hypertension (52% versus 22%) and diabetes (32% versus 6%), and higher values of mean nocturnal desaturation. Patients with iVAT had, in comparison to those with nVAT, lower values of the lumbar spine trabecular bone score (TBS; mean 1.24 versus 1.39;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), TBS T\u2010score (mean \u22121.82 versus \u22120.52;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and TBS Z\u2010score (mean \u22120.35 versus 0.75;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002). Moreover, a close association was present between the VAT index and TBS lumbar spine L1\u2013L4 (\n                    <jats:italic>r<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    linear 0.573;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and altered values of the TBS Z\u2010score were associated with the severity of vertebral fractures. Finally, in a linear regression\u2010adjusted model, the VAT index predicted TBS lumbar spine L1\u2013L4 (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u22120.323;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). In patients with OSA VAT impacts bone quality. In these patients, the role of VAT as a metabolically active tissue should be considered.\n                  <\/jats:p>","DOI":"10.1111\/jsr.14397","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T21:38:11Z","timestamp":1733866691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of the visceral adipose tissue on bone quality in patients with untreated mild\u2010to\u2010severe obstructive sleep apnea"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1283-4718","authenticated-orcid":false,"given":"Giulia","family":"Sartori","sequence":"first","affiliation":[{"name":"Department of Medicine, Respiratory Medicine Unit University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5175-7340","authenticated-orcid":false,"given":"Francesco","family":"Bertoldo","sequence":"additional","affiliation":[{"name":"Emergency Medicine Unit, Department of Medicine University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Gretter","sequence":"additional","affiliation":[{"name":"Department of Medicine, Respiratory Medicine Unit University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica Margherita","family":"Lovati","sequence":"additional","affiliation":[{"name":"Department of Medicine, Respiratory Medicine Unit University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosaria","family":"Caprino","sequence":"additional","affiliation":[{"name":"Department of Medicine, Respiratory Medicine Unit University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Viterale","sequence":"additional","affiliation":[{"name":"Department of Medicine, Respiratory Medicine Unit University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7298-7084","authenticated-orcid":false,"given":"Ernesto","family":"Crisafulli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Respiratory Medicine Unit University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona  Verona 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