Sleep Quality and Atherogenic Risk in Sleep Apnea Patients

Abstract

Objective: Some studies have shown the atherogenic dyslipidemia as being sometimes independent of the obesity; however, with a close relation to the obstructive sleep apnea (OSA). The aim of this study was to investigate a relationship between parameters defining the quality of sleep and the standard lipid profile despite the obesity. Methods: The data of 211 patients with suspected OSA were analyzed prospectively. The following tests were performed: polysomnography, morphometric assessment and serum lipid levels. Results: Value of AHI showed a positive correlation with TG, TG/HDL ratio, BMI, plasma atherogenic index (API), circumference of neck, waist, and hip, and WHR. A negative correlation was found between AHI and HDL. The patients with severe OSA (AHI>30) differ significantly from the patients with moderate and mild OSA in terms of TG, and the ratio of TG /HDL and API and they are, therefore, in the group of much higher risk of cardiovascular disease. Significant predictors of the severity of sleep apnea are as follow: the ratio of TG/HDL, BMI and the neck circumference. The arousal index was the only parameter of the sleep quality significantly associated with the level of TG. Conclusion: The most important parameters of the quality of sleep that determine atherogenic risk are AHI and arousal index that are significantly correlated with TG/HDL ratio. Particularly, high risk of cardiologic problems applies to patients with AHI>30 who substantially differ in terms of lipid profile from the patients with mild or moderate OSA. Arousal index significantly distinguishes patients with AHI> 30 from the other groups of patients.

Composite lipid indices in patients with obstructive sleep apnea: a systematic review and meta-analysis

“…After excluding patients in the study by Bikov et al [ 28 ], because patients were similar to another study published in 2022 [ 7 ], 14,943 cases (OSA and non-OSA) were evaluated in included studies. Eight studies evaluated AIP [ 7 , 8 , 28 , 29 , 31 – 33 , 35 ], while five studies evaluated LAP [ 5 , 7 , 27 , 34 , 36 ], and five studies evaluated VAI [ 7 , 20 , 30 , 34 , 36 ]. Table 1 summarizes the details of the studies along with their main findings.…”

Atherogenic Index of Plasma in Obstructive Sleep Apnoea

“…They found that AIP was higher in OSA and was related to AHI [ 21 ]. Wysocki et al investigated 211 patients with OSA and found a significant relationship between AHI and AIP; however, the authors did not recruit any controls [ 22 ]. Finally, Silva et al compared patients with mild OSA to controls and found increased TGs/HDL-C ratio in the OSA group.…”

“…Lower TC levels in the OSA group were, therefore, likely due to an increased usage of statins in these patients. In the previous studies, patients on statins were either included [ 19 , 22 ], excluded [ 21 ], or the results were adjusted for statin usage [ 18 , 23 ]. Nevertheless, excluding patients on statins did not change our conclusions on AIP.…”

“…Although both PSG and cardiorespiratory polygraphy are validated tests to diagnose OSA, PSG is a more sensitive and specific tool, as it measures the sleep time precisely and takes into account arousals when defining hypopneas [ 36 ]. Most of the previous studies used PSG [ 19 , 21 , 22 , 23 ]. To make our results more comparable with the previous one, we performed a separate analysis on the data from subjects who had polysomnography as a diagnostic test.…”

“…Only six studies have investigated TG/HDL-C ratio or AIP in OSA [ 18 , 19 , 20 , 21 , 22 , 23 ], but only four of them compared patients with OSA to non-OSA controls [ 14 , 15 , 21 , 23 ]. Three of these studies were conducted in Eastern Asia [ 14 , 15 , 21 ] and one in Brazil [ 23 ].…”