{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T22:43:51Z","timestamp":1778107431620,"version":"3.51.4"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"979","license":[{"start":{"date-parts":[[2007,5,1]],"date-time":"2007-05-01T00:00:00Z","timestamp":1177977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Syndrome Z describes the interaction of obstructive sleep apnoea (OSA) with the metabolic syndrome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Purpose of study<\/jats:title>\n                  <jats:p>A pilot study to determine the prevalence of syndrome Z in a teaching hospital in Singapore.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients (age \u2a7e18 years) recruited for this prospective study had to satisfy three of the following five inclusion criteria: fasting glucose &amp;gt;6.1 mmol\/l, blood pressure \u2a7e130\/85 mm Hg, HDL cholesterol &amp;lt;1.04 mmol\/l in men and &amp;lt;1.2 mmol\/l in women, triglycerides \u2a7e1.7 mmol\/l, and a waist circumference &amp;gt;102 cm in men and &amp;gt;88 cm in women. All subjects underwent standard overnight polysomnography. Overnight fasting glucose and lipid levels were measured and baseline anthropometric data recorded. All sleep studies were scored and reported by a sleep physician. OSA was deemed to be present if the respiratory disturbance index (RDI) was \u2a7e5, with mild, moderate and severe categories classified according to the Chicago criteria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 24 patients (19 males and five females) of whom 10 were Chinese, eight Malay and five of Indian origin, with one other. Mean age was 48\u00b113.5 years, mean body mass index was 34.9\u00b16.1 kg\/m2 and mean waist circumference was 111.3\u00b115.7 cm. 23 (95.8%) of the patients had OSA with a mean RDI of 39.6\u00b122.4 events\/h with 15 patients (62.5%) in the severe category. The five patients who fulfilled all five criteria for diagnosis of the metabolic syndrome had severe OSA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The prevalence of OSA in our studied population exhibiting the metabolic syndrome is very high. Therefore, a polysomnogram should always be considered for this subset of patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/pgmj.2006.051805","type":"journal-article","created":{"date-parts":[[2007,5,8]],"date-time":"2007-05-08T17:03:14Z","timestamp":1178643794000},"page":"329-331","source":"Crossref","is-referenced-by-count":22,"title":["The prevalence of syndrome Z (the interaction of obstructive sleep apnoea with the metabolic syndrome) in a teaching hospital in Singapore"],"prefix":"10.1093","volume":"83","author":[{"given":"Sridhar","family":"Venkateswaran","sequence":"first","affiliation":[{"name":"Department of Medicine, Changi General Hospital , Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praveen","family":"Shankar","sequence":"additional","affiliation":[{"name":"Changi General Hospital , Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2007,5,8]]},"reference":[{"key":"2023042013043096600_bib1","first-page":"S25","article-title":"\u201cSyndrome Z\u201d: the interaction of sleep apnoea, vascular risk factors and heart disease","volume":"53","author":"Wilcox","year":"1998","journal-title":"Thorax"},{"key":"2023042013043096600_bib2","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1056\/NEJM199304293281704","article-title":"The occurrence of sleep-disordered breathing among middle-aged adults","volume":"328","author":"Young","year":"1993","journal-title":"N Engl J Med"},{"key":"2023042013043096600_bib3","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1001\/archinte.163.4.427","article-title":"The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988\u20131994","volume":"163","author":"Park","year":"2003","journal-title":"Arch Intern Med"},{"key":"2023042013043096600_bib4","doi-asserted-by":"crossref","first-page":"2486","DOI":"10.1001\/jama.285.19.2486","article-title":"Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)","volume":"285","author":"Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults","year":"2001","journal-title":"JAMA"},{"key":"2023042013043096600_bib5","first-page":"1","article-title":"An American Heart Association\/National Heart, Lung, and Blood Institute Scientific Statement. Executive summary","volume":"112","author":"Grundy","year":"2005","journal-title":"Circulation"},{"key":"2023042013043096600_bib6","article-title":"A manual of standardized terminology techniques and scoring system for sleep stages of human sleep","author":"Rechtschaffen","year":"1968","journal-title":"Los Angeles: Brain Information Service\/Brain Research Institute, UCLA"},{"key":"2023042013043096600_bib7","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1093\/sleep\/22.5.667","article-title":"Sleep-related breathing disorders in adults: recommendation for syndrome definition and measurement techniques in clinical research","volume":"22","author":"American Academy of Sleep Medicine Task Force","year":"1999","journal-title":"Sleep"},{"key":"2023042013043096600_bib8","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1183\/09031936.02.00404502","article-title":"Public health and medicolegal implications of sleep apnoea","volume":"20","author":"Krieger","year":"2002","journal-title":"Eur Respir J"},{"key":"2023042013043096600_bib9","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1056\/NEJM200005113421901","article-title":"Prospective study of the association between sleep-disordered breathing and hypertension","volume":"342","author":"Peppard","year":"2000","journal-title":"N Engl J Med"},{"key":"2023042013043096600_bib10","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1001\/jama.283.14.1829","article-title":"Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study","volume":"283","author":"Nieto","year":"2000","journal-title":"JAMA"},{"key":"2023042013043096600_bib11","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1164\/ajrccm.163.1.2001008","article-title":"Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study","volume":"163","author":"Shahar","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"key":"2023042013043096600_bib12","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1164\/rccm.2105124","article-title":"Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up","volume":"166","author":"Peker","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"key":"2023042013043096600_bib13","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1183\/09031936.04.00061503","article-title":"Sleep-related breathing disorders: impact on mortality of cerebrovascular disease","volume":"24","author":"Parra","year":"2004","journal-title":"Eur Respir J"},{"key":"2023042013043096600_bib14","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1164\/ajrccm.165.5.2103001","article-title":"Obstructive sleep apnea is independently associated with insulin resistance","volume":"165","author":"Ip","year":"2002","journal-title":"Am J Crit Care Med"},{"key":"2023042013043096600_bib15","doi-asserted-by":"crossref","first-page":"2076","DOI":"10.1378\/chest.127.6.2076","article-title":"Long term effects of nasal continuous positive airway pressure therapy on cardiovascular outcomes in sleep apnea syndrome","volume":"127","author":"Doherty","year":"2005","journal-title":"Chest"},{"key":"2023042013043096600_bib16","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1016\/j.rmed.2005.10.003","article-title":"Obstructive sleep apnea and the metabolic syndrome in community-based Chinese adults in Hong Kong","volume":"100","author":"Lam","year":"2006","journal-title":"Respir Med"},{"key":"2023042013043096600_bib17","first-page":"43","volume-title":"Type 2 diabetes. Practical targets and treatments","author":"Asian-Pacific Type 2 Diabetes Policy Group","year":"2005","edition":"4th edn"},{"key":"2023042013043096600_bib18","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.2337\/diacare.27.5.1182","article-title":"Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians?","volume":"5","author":"Tan","year":"2004","journal-title":"Diabetes Care"},{"key":"2023042013043096600_bib19","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/S0140-6736(02)09512-0","article-title":"WHO reassesses appropriate body-mass index for Asian populations","volume":"360","author":"Choo","year":"2002","journal-title":"Lancet"},{"key":"2023042013043096600_bib20","author":"Singapore Department of Statistics","year":"2007","journal-title":"Singapore: Census 2000. Key Indicators of Resident Population by Ethnic Group (2nd January 2000)"},{"key":"2023042013043096600_bib21","first-page":"18","article-title":"The metabolic syndrome: an Asian perspective","volume":"51","author":"Chan","year":"2006","journal-title":"Diabetes Voice"},{"key":"2023042013043096600_bib22","author":"Ministry of Health, Singapore","year":"2005","journal-title":"Singapore: Details of National Health Survey 2004 Findings"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/83\/979\/329\/50023179\/postgradmedj-83-329.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/83\/979\/329\/50023179\/postgradmedj-83-329.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T15:45:12Z","timestamp":1682005512000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/83\/979\/329\/7045378"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,5,1]]},"references-count":22,"journal-issue":{"issue":"979","published-online":{"date-parts":[[2007,5,8]]},"published-print":{"date-parts":[[2007,5,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.2006.051805","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2007,5]]},"published":{"date-parts":[[2007,5,1]]}}}