Alterations of cholesterol synthesis and absorption in obstructive sleep apnea: Influence of obesity and disease severity

Zeljković, Aleksandra; Milojević, Ana; Vladimirov, Sandra; Zdravković, Marija; Memon, Lidija; Brajković, Milica; Gardijan, Vera; Gojković, Tamara; Stefanović, Aleksandra; Miljković-Trailović, Milica; Spasojević‐Kalimanovska, Vesna; Ninić, Ana

doi:10.1016/j.numecd.2022.09.006

Cited by 7 publications

(4 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Research by Fadaei et al and Zeljković et al and their respective teams discovered that cholesterol synthesis is signi cantly elevated in patients with obstructive sleep apnea (OSA), while the e ux capacity of high-density lipoprotein cholesterol (HDL) is markedly diminished. This reduction is closely associated with the severity of OSA, obesity, and in ammatory conditions [39,40].Exploring the connection between obstructive sleep apnea (OSA) and the ratio of non-high-density lipoprotein cholesterol (non-HDL) to high-density lipoprotein cholesterol (HDL), or NHHR, reveals that chronic intermittent hypoxia (CIH) is essential [41]. According to existing literature, CIH is a persistent characteristic of OSA that not only elevates non-HDL but may also compromise the functionality and levels of HDL, thereby impacting NHHR.…”

Section: Discussionmentioning

confidence: 99%

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and obstructive sleep apnea : a cross-sectional study

Chen,

Zou,

Lou

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Obstructive Sleep Apnea (OSA) is a common sleep disorder characterized by repeated instances of either partial or total blockage of the upper airway while sleeping. This leads to disrupted sleep and several related health issues. The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a novel indicator that has the potential to provide more accurate assessment of the risk for cardiovascular and cerebrovascular illnesses. This study sought to explore the relationship between NHHR and OSA. Methods This research included cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2008, as well as between 2015 and 2018. The study included a total of 19,234 individuals. The NHHR was determined by dividing the non-high-density lipoprotein cholesterol by the high-density lipoprotein cholesterol. The participants were divided into quartiles according to their NHHR levels. OSA was characterized by symptoms described by the individuals themselves, such as extreme tiredness throughout the day, gasping or snorting during asleep, and frequent snoring. The link between NHHR and OSA was evaluated using multivariate logistic regression and segmented linear regression models. Results In this research, 19,234 individuals with a mean age of 41.88 ± 20.58 years were included. Among them, 50.46% were diagnosed with OSA. The mean and standard deviation for NHHR were measured as 3.08 ± 1.51.An elevated NHHR was shown to be substantially correlated with a higher risk of OSA, with an odds ratio (OR) of 1.113 and a 95% confidence interval (CI) ranging from 1.807 to 1.140 (p < 0.001). The observed correlation remained significant even after controlling for possible confounding variables such as age, gender, race, and other characteristics associated to health.An inverted U-shaped association was identified, which was nonlinear. The turning point of this relationship occurred at an NHHR value of 5.198.When the NHHR was below a certain level, each additional unit rise in NHHR resulted in a 17% increase in the risk of OSA. However, when the NHHR was beyond this level, the risk of OSA remained constant. Conclusions The presence of NHHR is a strong indicator of the probability of developing OSA. This highlights the crucial need to closely monitor and control lipid profiles in patients who have or are at risk of developing OSA. These findings provide fresh perspectives on the connection between lipid metabolism and OSA, indicating that NHHR might serve as a helpful indicator in clinical evaluations.

show abstract

Section: Discussionmentioning

confidence: 99%

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and obstructive sleep apnea : a cross-sectional study

Chen,

Zou,

Lou

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Eventually, OSA accelerates the adverse cardiovascular remodeling in patients with resistant hypertension [ 34 ]. OSA also contributes to dyslipidemia via upregulating involved enzymes to induce the increase of liver lipid synthesis [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of obstructive sleep apnea on prognosis in patients with acute coronary syndromes with varying numbers of standard modifiable risk factors: insight from the OSA-ACS study

Wang,

Zhang,

Hao

et al. 2023

J Thromb Thrombolysis

View full text Add to dashboard Cite

Background Standard modifiable risk factors (SMuRFs) increase the risk of cardiovascular events in patients with acute coronary syndrome (ACS) and are also strongly associated with obstructive sleep apnea (OSA) in a bidirectional relationship. However, the association of OSA with recurrent cardiovascular events in ACS patients based on the number of SMuRFs remains unclear. Hence, we aimed to elucidate the prognostic implication of OSA in ACS patients stratified by the number of SMuRFs. Methods This was a post hoc analysis of the OSA-ACS study (NCT03362385), including 1927 patients admitted for ACS and undergoing portable sleep monitoring. OSA was defined as an apnea hypopnea index ≥ 15 events/h. The primary endpoint was major adverse cardiovascular and cerebrovascular event (MACCE) including cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina or heart failure, and ischemia-driven revascularization. Cox proportional hazards model and Kaplan-Meier analysis were used to investigated the relationship between OSA and subsequent cardiovascular events after patients were stratified by the number of SMuRFs. Results Among 1927 patients enrolled, 130 (6.7%) had no SMuRF, 1264 (65.6%) exhibited 1–2 SMuRFs and 533 (27.7%) presented 3–4 SMuRFs. With the increase of the number of SMuRFs, the proportion of OSA in ACS patients tended to increase (47.7% vs. 51.5% vs. 56.6%), but there was no significant difference between them (P = 0.08). After the stratification of ACS patients via SMuRF numbers and adjustment for confounding factors, fully adjusted Cox regression indicated that OSA increased the risk of MACCE (adjusted HR, 1.65; 95%CI, 1.06–2.57; P = 0.026) and ischemia-driven revascularization (adjusted HR, 2.18; 95%CI, 1.03–4.65; P = 0.042) in ACS patients with 3–4 SMuRFs. Conclusions In hospitalized ACS patients, OSA is associated with an increased risk of MACCE and ischemia-driven revascularization among patients with 3–4 SMuRFs. Therefore, screening for OSA should be emphasized in ACS patients with 3–4 SMuRFs, and intervention trials should be prioritized in these high-risk patients.

show abstract

“…Circulatory endogenous precursors of cholesterol can be used as markers of cholesterol synthesis, while phytosterols, which use the same absorption route as cholesterol, are proposed as cholesterol absorption markers (Figure 4) [122]. Cholesterol synthesis and absorption are reciprocally regulated in healthy individuals, but it has been demonstrated that various pathological states are characterized by the disturbance of the balance between these processes [123][124][125][126][127][128][129][130]. Accordingly, non-cholesterol sterols could be used, not only as indicators of altered cholesterol homeostasis, but also as markers of several diseases, including CVD, and predictors of therapeutic response.…”

Section: Biomarkers Of Oxidative Stress and Atherogenic Dyslipidemia:...mentioning

confidence: 99%

Oxidative Stress, Atherogenic Dyslipidemia, and Cardiovascular Risk

Vekic,

Stromsnes,

Mazzalai

et al. 2023

Biomedicines

Self Cite

View full text Add to dashboard Cite

Oxidative stress is the consequence of an overproduction of reactive oxygen species (ROS) that exceeds the antioxidant defense mechanisms. Increased levels of ROS contribute to the development of cardiovascular disorders through oxidative damage to macromolecules, particularly by oxidation of plasma lipoproteins. One of the most prominent features of atherogenic dyslipidemia is plasma accumulation of small dense LDL (sdLDL) particles, characterized by an increased susceptibility to oxidation. Indeed, a considerable and diverse body of evidence from animal models and epidemiological studies was generated supporting oxidative modification of sdLDL particles as the earliest event in atherogenesis. Lipid peroxidation of LDL particles results in the formation of various bioactive species that contribute to the atherosclerotic process through different pathophysiological mechanisms, including foam cell formation, direct detrimental effects, and receptor-mediated activation of pro-inflammatory signaling pathways. In this paper, we will discuss recent data on the pathophysiological role of oxidative stress and atherogenic dyslipidemia and their interplay in the development of atherosclerosis. In addition, a special focus will be placed on the clinical applicability of novel, promising biomarkers of these processes.

show abstract

Alterations of cholesterol synthesis and absorption in obstructive sleep apnea: Influence of obesity and disease severity

Cited by 7 publications

References 31 publications

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and obstructive sleep apnea : a cross-sectional study

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and obstructive sleep apnea : a cross-sectional study

Effect of obstructive sleep apnea on prognosis in patients with acute coronary syndromes with varying numbers of standard modifiable risk factors: insight from the OSA-ACS study

Oxidative Stress, Atherogenic Dyslipidemia, and Cardiovascular Risk

Contact Info

Product

Resources

About