Association of Plasma Homocysteine with Self-Reported Sleep Apnea Is Confounded by Age: Results from the National Health and Nutrition Examination Survey 2005-2006

Abstract

High levels of plasma homocysteine are implicated in the pathogenesis of cardiovascular diseases especially if accompanied by sleep apnea, but a direct pathogenetic link between plasma homocysteine levels and obstructive sleep apnea is debatable. This association can have far-reaching public health implications considering the inverse association between folate and plasma homocysteine. We used data from the 2005-2006 cycle of the National Health and Nutrition Examination Survey (NHANES) to test the hypothesized associations. Of the 4490 subjects included in analysis, 177 reported sleep apnea. Age-standardized and design-effect-corrected prevalence rates were differential across gender, plasma homocysteine, and red cell folate status. Plasma homocysteine was positively correlated with age (r = 0.38, P < 0.0001). Multivariate analyses using sociodemographic and clinical covariates demonstrated that plasma homocysteine levels retained their respective associations with self-reported sleep apnea in all models except when age was included as a covariate. Our results demonstrate that the claimed association of plasma homocysteine with sleep apnea may be confounded by age.

Serum Nutritional Biomarkers and Their Associations with Sleep among US Adults in Recent National Surveys

“…Moreover, low serum folate has been associated with restless leg syndrome among pregnant women [23] . Higher tHcy was linked to an increased risk of obstructive sleep apnea in some studies [24] , [25] but not others [79] , [80] . Despite evidence of a protective effect of vitamins C and E on sleep quality [26] , [44] , [81] , our study did not find an independent association between these two antioxidants and the sleep measures under study.…”

Risk factors of atherosclerosis in elderly senile obstructive sleep apnea hypopnea syndrome patients with hypertension and type 2 diabetes

“…Both OSAHS and Hcy are considered as independent risk factors for cardiovascular disease. [11] Thakre et al [12] have found that the level of Hcy in OSAHS people was significantly higher than that in non-OSAHS people, Sales et al [13] also came to similar results in their research. Animal models have confirmed that the level of Hcy in OSAHS rats is higher than that in non-OSAHS rats; hypoxic changes in OSAHS rats may result from the fact that increased level of Hcy enhances inflammatory responses in the body and leads to the occurrence of AS in cerebral arteries.…”

Homocysteine level in patients with obstructive sleep apnea/hypopnea syndrome and the impact of continuous positive airway pressure treatment

“…of cardiovascular disease, and its levels were independently associated with the severity of OSAHS. [14][15][16] Meanwhile, Monneret et al demonstrated that the serum Hcy levels were higher in OSAHS with metabolic syndrome compared to metabolic syndrome patients, and proportional to the severity of OSAHS. 17 However, Cintra et al observed that the Hcy plasma levels did not differ between OSAHS patients and the control subjects that were matched for age and sex.…”