0546 A Cross-Population Comparison of Sleep-Disordered Breathing in European and East Asian Adults

Abstract Introduction Sleep-disordered breathing (SDB) is a major global health concern with substantial cardiometabolic consequences, yet its determinants and physiological expression may differ across populations. This study used harmonised data from the Study of Health in Pomerania (SHIP) in Germany and the Korean Genome and Epidemiology Study (KoGES) in South Korea to examine ethnic differences in SDB prevalence, correlates, and metabolic profiles in European and East Asian adults. Methods Participants aged 45 years and older with at least four hours of valid sleep data were included. Demographic, anthropometric, behavioural, and cardiometabolic variables were harmonised to ensure comparability. Age and sex distributions were balanced using inverse probability weighting. SDB severity was defined using apnea–hypopnea index thresholds. Regression models with cohort-by-severity interaction terms evaluated population-specific associations, adjusting for age, sex, and waist-to-height ratio (WHtR), selected for its cross-ethnic comparability. Results Before adjustment, SHIP participants exhibited higher BMI and WHtR, while KoGES participants showed higher diabetes prevalence and elevated HbA1c. In both cohorts, SDB prevalence increased with age and was higher in men. Anthropometric indices rose with increasing severity in both populations, but gradients were steeper in SHIP, indicating a stronger adiposity-linked pathway. Cardiometabolic profiles diverged: in SHIP, greater severity was associated with elevated LDL cholesterol, triglycerides, and hypertension, whereas in KoGES it was linked to increased HbA1c and diabetes prevalence. Adjustment for WHtR reduced inter-cohort differences in lipid and blood pressure markers but did not eliminate disparities in glycaemic outcomes, suggesting distinct metabolic susceptibility. Conclusion Although central adiposity is a shared determinant of SDB, the physiological consequences of higher severity differ across populations. In the European cohort, SDB was more strongly linked to vascular and lipid-related burden, whereas in the East Asian cohort it was more closely associated with impaired glucose regulation, reflecting heightened glycaemic vulnerability. These population-specific patterns likely stem from differences in fat distribution, metabolic risk, and lifestyle transitions. Overall, SDB manifests through distinct pathways across populations, underscoring the need for tailored screening and management strategies rather than universal clinical models. Support (if any)