Distinct severity stages of obstructive sleep apnoea are correlated with unique dyslipidaemia: large-scale observational study

Abstract

BackgroundDyslipidaemia is an intermediary exacerbation factor for various diseases but the impact of obstructive sleep apnoea (OSA) on dyslipidaemia remains unclear.MethodsA total of 3582 subjects with suspected OSA consecutively admitted to our hospital sleep centre were screened and 2983 (2422 with OSA) were included in the Shanghai Sleep Health Study. OSA severity was quantified using the apnoea–hypopnea index (AHI), the oxygen desaturation index and the arousal index. Biochemical indicators and anthropometric data were also collected. The relationship between OSA severity and the risk of dyslipidaemia was evaluated via ordinal logistic regression, restricted cubic spline (RCS) analysis and multivariate linear regressions.ResultsThe RCS mapped a nonlinear dose–effect relationship between the risk of dyslipidaemia and OSA severity, and yielded knots of the AHI (9.4, 28.2, 54.4 and 80.2). After integrating the clinical definition and RCS-selected knots, all subjects were regrouped into four AHI severity stages. Following segmented multivariate linear modelling of each stage, distinguishable sets of OSA risk factors were quantified: low-density lipoprotein cholesterol (LDL-C), apolipoprotein E and high-density lipoprotein cholesterol (HDL-C); body mass index and/or waist to hip ratio; and HDL-C, LDL-C and triglycerides were specifically associated with stage I, stages II and III, and stages II–IV with different OSA indices.ConclusionsOur study revealed the multistage and non-monotonic relationships between OSA and dyslipidaemia and quantified the relationships between OSA severity indexes and distinct risk factors for specific OSA severity stages. Our study suggests that a new interpretive and predictive strategy for dynamic assessment of the risk progression over the clinical course of OSA should be adopted.

Hyperlipidaemia prevalence and cholesterol control in obstructive sleep apnoea: Data from the European sleep apnea database (ESADA)

“…Kono et al [26] demonstrated an association between OSA and components of metabolic syndrome including hypertension, dyslipidaemia and hyperglycaemia in a nonobese male population. In the study of Guan et al [27], a nonlinear dose-effect relationship between dyslipidaemia and OSA severity has been reported. In the Hypnolaus study investigating the prevalence of OSA in a general population with a mean BMI of 25.6 kg/m 2 , a 30% (n = 641) prevalence of metabolic syndrome as well as independent association between OSA and metabolic syndrome has been reported [1].…”

A U-Shaped Relationship between Fasting Plasma Glucose and Severity of Sleep Apnea

“…[30] In our study, severity of OSAS was inversely correlated with HDL values, low values of which are a strong cardiovascular risk factor.…”

Association of upper airway surgery and improved cardiovascular biomarkers and risk in OSA

“…Smoking habits and medical histories, including nature of the disease, timing of first diagnosis, and treatments, were also noted. Patients were divided into current and noncurrent smokers, as described in our previous study . Blood pressure was measured to the nearest 2 mm Hg by calibrated mercury sphygmomanometry, with all patients sitting after at least 5 minutes rest.…”

“…Patients were divided into current and noncurrent smokers, as described in our previous study. 19 Blood pressure was measured to the nearest 2 mm Hg by calibrated mercury sphygmomanometry, with all patients sitting after at least 5 minutes rest. The means of three measurements were calculated.…”