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The Role of Sleep in Mediating the Relationship Between BMI and CVD Risk Factors in Samoan Adults

McKune, Molly Elizabeth (2021) The Role of Sleep in Mediating the Relationship Between BMI and CVD Risk Factors in Samoan Adults. Master's Thesis, University of Pittsburgh. (Unpublished)

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Background: Previous research shows an association between higher BMI and higher cardiovascular disease (CVD) risk, as well as an association between poor sleep quality and higher CVD risk, but minimal research has been conducted in this area with Samoan adults. Samoan adults have a higher BMI than average, partially due to a variant found in their CREBRF (CREB 3 regulatory factor) gene. Due to genetic tendency to have higher BMI, it is imperative to identify factors that can mitigate the impact of high BMI on CVD risk, such as sleep quality.
Objective: From a cohort selected from the GWAS which identified the CREBRF genetic variant, sleep quality and CVD risk factor data was collected. This cohort is known as The Soifua Manuia (Good Health) Study. The objective of this paper is to identify sleep quality measures which mediate the relationship between BMI and CVD risk using these participants.
Methods: Path Analysis, a form of structural equation modeling, was performed on 503 participants to quantify the relationship between BMI, Sleep Quality, and CVD risk, and identify statistically significant evidence of a causal pathway where sleep quality mediates the relationship between BMI and CVD risk.
Results: Three path analyses were found to be significant. Sleep disordered breathing (AHI 3%) was found to mediate the relationship between BMI and both HDL cholesterol levels and diastolic blood pressure (p < 0.05). Snoring volume was found to mediate the relationship between BMI and HDL cholesterol (p < 0.2). In all significant models, an improvement in the sleep quality measure was associated with an improvement in CVD risk factor on average.
Conclusions: The data preliminarily shows that improvements in sleep disordered breathing and snoring volume could help mitigate the impact of BMI on HDL cholesterol and diastolic blood pressure. These data present evidence that many Samoan adults have some form of sleep disordered breathing and undiagnosed sleep apnea. The public health significance of these results is to have identified compelling evidence of the need for a public health intervention in Samoan adults to diagnose and treat sleep apnea to improve sleep quality.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
McKune, Molly Elizabethmem344@pitt.edumem3440000-0002-0097-0627
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCarlson, Jennajnc35@pitt.edujnc35
Committee MemberYouk, Adaayouk@pitt.eduayouk
Committee MemberBuchanich, Jeaninejeanine@pitt.edujeanine
Committee MemberCostacou, Tinacostacout@edc.pitt.educostacout
Date: 12 May 2021
Date Type: Publication
Defense Date: 26 April 2021
Approval Date: 12 May 2021
Submission Date: 29 April 2021
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 59
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Path Analysis, Sleep Quality, Samoa, CREBRF, BMI, CVD
Date Deposited: 13 May 2021 02:46
Last Modified: 12 May 2023 05:15


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