Do Obesity and Obstructive Sleep Apnea Contribute to Sarcoidosis Development?

A study of sarcoidosis assessed the extent to which increasing BMI and obstructive sleep apnea were associated with disease development.

Sarcoidosis development was not associated with high body mass index (BMI), and obstructive sleep apnea (OSA) seemed to protect against the development of sarcoidosis, according to findings of a retrospective study recently published in Chest.

Past research has shown a link between BMI and sarcoidosis, but the relationship between obesity and the inflammatory condition has yet to be conclusively established. Researchers based in Albany, New York, sought to determine whether BMI was associated with patients’ development of sarcoidosis, as well as the effect of OSA, which is common in those with high BMI, on sarcoidosis development.

The investigators analyzed patient information collected between October 1999 and April 2021 from a cohort of patients with sarcoidosis (N=10,512) and a control group of patients without sarcoidosis (N=2,709,884) from the US Veterans Administration Informatics and Computing Infrastructure electronic health database.   

The sarcoidosis group included a higher percentage of women, Black patients, and younger patients than the nonsarcoidosis cohort. In general, women had increased odds of sarcoidosis compared with men, and Black patients had higher chances of developing the disease than White patients. Older age also increased the risk for sarcoidosis.

No link was found between BMI and the rate of sarcoidosis (30.9 vs 31.0, P =0.18) as validated by post hoc statistical power calculations. The investigators also found that the mean BMI of patients in the sarcoidosis group was lower than in the nonsarcoidosis group.

With respect to OSA, researchers found that the sarcoidosis cohort included a smaller proportion of individuals diagnosed with OSA vs the control cohort (16.8%; P <.0001), a result that was statistically significant. Likewise, patients with OSA had a lower odds of being diagnosed with sarcoidosis (adjusted logistic regression model: odds ratio [OR], 0.525; 95% CI, 0.492-0.560; conditional logistic regression model: OR, 0.510; 95% CI, 0.478-0.545) (OR, 0.510; 95% CI, 0.478-0.545). These findings are unique and previously unexplored.

“Using our adjusted logistic regression model at 12 months prior to the diagnosis of sarcoidosis, there was a 47.5% lower odds of sarcoidosis in OSA patients compared to patients without a diagnosis of OSA,” they explained.

Study limitations included potentially inaccurate or delayed diagnosis or imprecise weight data. However, authors noted that these factors influenced results only minimally.

“Our analysis failed to demonstrate that BMI is associated with the subsequent development of sarcoidosis over the next year,” the study researchers stated. “These findings contradict other smaller analyses and reopen the question of the association of BMI and OSA with the development of sarcoidosis,” they concluded.

Disclosure: Multiple authors declared affiliations with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.


Judson MA, Tiwari A, Gemoets DE. The relationship of obesity and obstructive sleep apnea to the development of sarcoidosis: a large retrospective case-control US Veterans Administration analysis. Chest. Published May 18, 2022. doi:10.1016/j.chest.2022.05.008

This article originally appeared on Pulmonology Advisor