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4,5 OSA is a common and increasingly recognized sleep disorder, characterized by recurrent episodes of upper airway collapse that results in oxyhaemoglobin desaturation and periodic arousals from sleep throughout the night.6 Obesity is a well-known risk factor for OSA;7 this website therefore, OSA is possibly an additive pathogenic pathway for the effects of obesity on cardiometabolic dysfunction. There is emerging evidence that obesity and OSA affect similar cascades that contribute to vasculopathy.8 Obesity develops from an imbalance of energy over time, when energy intake exceeds energy expenditure, leading to accumulation of adipose tissue with a corresponding increase in lean body mass.9 Its severity also depends on a complex interaction of genetic and environmental influences. It is often defined in terms of BMI by body weight relative to height, or evaluated in terms of fat distribution for central obesity with measurements of waist circumference or waist-to-hip ratio. The cut-off value of BMI for obesity in the Caucasian populations is at 30?kg/m2, but some Asian populations have redefined obesity at a lower BMI of 25?kg/m2.10 The World Health Organization taskforce on obesity suggested that Asian populations have different associations between BMI, percentage of body fat, and health risks than do Caucasians. The consultation concluded that the proportion of Asian people with a high risk of type 2 diabetes and cardiovascular disease is substantial at BMIs Veliparib supplier expert consultation further identified potential public health action points (23, 27.5, 32.5, 37.5?kg/m2) along the continuum of BMI for Asian populations.11 Obesity and central obesity have significant adverse impact on health, yet they are modifiable and thus preventable causes of morbidity and mortality. In a collaborative analysis of 57 prospective studies with nearly 900?000 participants from Western Europe and North America,3 it was found that, for each 5?kg/m2 increase in BMI, overall mortality was increased by 30%, with a hazard ratio of 1.29. For each 5?kg/m2, mortality was increased by 40% for vascular diseases, 60�C120% for diabetic, renal and hepatic diseases, 20% for respiratory disease, and 10% for cancer. DDR1 At BMI 30�C35?kg/m2, median survival is reduced by 2 to 4?years; at 40�C45?kg/m2, it is reduced by 8�C10?years. The most common and most deleterious effects of obesity are on the cardiovascular system, predisposing to hypertension, ischaemic heart disease and cerebrovascular accident, with a putative mechanistic link to increased sympathetic drive on the vasculature.12 It is apparent that a variety of adaptations or alterations in cardiac structure and function occur as excessive adipose tissue accumulates, even in the absence of systemic hypertension or underlying organic heart disease.