Elevated low-density lipoprotein cholesterol is independently associated with obstructive sleep apnea: evidence from a large-scale cross-sectional study

Xu, Huajun; Guan, Jian; Yi, Hongliang; Zou, Jian; Meng, Lili; Tang, Xiuzhen; Zhu, Huaming; Yu, Dongzhen; Zhou, Huiqun; Su, Kaiming; Wang, Yue; Wang, Jian; Yin, Shankai

doi:10.1007/s11325-015-1262-3

Cited by 43 publications

(32 citation statements)

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“…The detrimental effects of OSAS in patients with dyslipidemia have been well-documented. More patients with OSAS have dyslipidemia than subjects without OSAS, and only LDL-C is independently associated with OSAS 6 . CPAP treatment significantly decreases the TC level, with slight changes in TG, HDL, and LDL-C levels 7 .…”

Section: Discussionmentioning

confidence: 96%

“…Standardized anthropometric parameters, including waist circumference (WC), hip circumference (HC) and neck circumference (NC), were measured using standard methods as described previously 6 . These anthropometric data were recorded as the mean of two measurements.…”

Section: Methodsmentioning

confidence: 99%

“…The association between dyslipidemia, which is an important risk factor for cardiovascular diseases (CVDs), and OSAS has been studied 5 . Several clinical studies have revealed that OSAS is independently associated with particular lipids and that continuous positive airway pressure (CPAP) therapy can reverse the dyslipidemic status of patients with OSAS 6 , 7 . Similarly, OSAS is independently associated with impaired glucose metabolism, including fasting hyperglycemia and insulin resistance, and CPAP has a favorable effect on insulin resistance 8 , 9 .…”

Section: Introductionmentioning

confidence: 99%

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Smoking, obstructive sleep apnea syndrome and their combined effects on metabolic parameters: Evidence from a large cross-sectional study

Zhu

Chen

et al. 2017

Sci Rep

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Metabolic disorders have been separately associated with obstructive sleep apnea syndrome (OSAS) and smoking. However, no study has examined their interactions with metabolic parameters, including insulin resistance and dyslipidemia. To investigate whether the combination of OSAS and smoking results in an additive detriment in metabolic disorder parameters, we enrolled consecutive adult men during 2014–2015. Fasted blood samples were taken to determine glucose, insulin, and lipid levels. A questionnaire including an item on smoking pack-year exposure was administered, and the Epworth Sleepiness Scale and overnight polysomnography were performed. Smokers showed higher levels of glucose, insulin, total cholesterol (TC), triglycerides (TG), and low density lipoprotein-cholesterol (LDL-C), but lower high-density lipoprotein cholesterol (HDL-C) levels, than did non-smokers. In addition, the risks for insulin resistance increased with OSAS severity without fully adjustment. An OSAS × smoking interaction was found in insulin resistance after adjusting for potential confounding factors (p = 0.025). Although the difference was not significant, cessation of cigarette smoking seems to have a little benefit for smoking patients with OSAS. A synergistic effect was observed between smoking and OSAS on metabolic disorder parameters. Cessation of cigarette smoking may experience minor benefit for insulin resistance and lipid metabolism in patients with OSAS.

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Smoking, obstructive sleep apnea syndrome and their combined effects on metabolic parameters: Evidence from a large cross-sectional study

Zhu

Chen

et al. 2017

Sci Rep

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“…Our large-sample-size study also confirms the positive association between the ApoB/ApoA-I and OSA and describes the nature of complex relationship between the two. One previous study showed that patients with OSA have independently elevated LDL, which decreased after adjustment for multiple factors [11,37]. Total ApoB reflects the number of total potentially atherogenic lipoprotein particles, and ApoA-I is involved in reverse cholesterol transport.…”

Section: Discussionmentioning

confidence: 99%

Interrelationships among common predictors of cardiovascular diseases in patients of OSA: A large-scale observational study

Fan

Qian

et al. 2020

Nutrition, Metabolism and Cardiovascular Diseases

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Background and aims: The apolipoprotein B/apolipoprotein A-I (ApoB/ApoA-I) and insulin resistance has been recognized as common cardiovascular diseases (CVD) risk factors. However, whether they were biomarkers for 10-year CVD risk in obstructive sleep apnea (OSA) had been rarely studied. Besides, interrelationships between the ApoB/ApoA-I, insulin resistance and OSA remain unclear. Methods and results: A total of 4010 subjects were finally included. Anthropometric, fasting biochemical, and polysomnographic parameters were collected. 10-year Framingham CVD risk score (FRS) was calculated for each subjects. The relationships between insulin resistance, OSA risk and the ApoB/ApoA-I was evaluated through logistic regressions analysis, restricted cubic spline (RCS) analysis and mediation analysis. ApoB/ApoA-I, HOMA-IR and AHI were all risk factors for high10-year CVD risk as assessed by FRS (odds ratios (OR) Z 5.365, 1.094, 1.010, respectively, all P < 0.001)). The fully adjusted OR (95% confidence intervals) for both OSA [1 (reference), 1.308 (1.027e1.665), 1.517 (1.178e1.953), and 1.803 (1.371e2.372)] and insulin resistance [1 (reference), 1.457 (1.173e1.711), 1.701 (1.369e2.113), 2.051(1.645e2.558)] increased from the first to the fourth quartiles of the ApoB/ApoA-I. The RCS mapped a nonlinear doseeeffect relationship between the ApoB/ApoA-I and risk of insulin resistance and OSA. Mediation analyses showed HOMA-IR explain 9.7%, 4.7% and 10.8% of the association between apnea-hypopnea index, oxygen desaturation index, micro-arousal index and ApoB/ApoA-I, respectively. Conclusions: Our study revealed that ApoB/ApoA-I, insulin resistance and OSA were risk factors for CVD. Insulin resistance may serve as a potential mediator in OSA-related lipoprotein disorders and further increase CVD risk.

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“…The SPOSA is a weighted model containing comorbidity and demographic variables known to be associated with OSA, including: chronic pulmonary disease [35], congestive heart failure [5, 6], diabetes [7], dyslipidemia [36, 37], hypertension [3, 38], atrial fibrillation [39, 40], liver disease [41], coronary artery disease [42], and pulmonary hypertension [43, 44]. The association between hemiplegia/paraplegia and OSA may be related to the an association between OSA and acute ischemic stroke [4, 45].…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a Score for Preoperative Prediction of Obstructive Sleep Apnea (SPOSA) and its perioperative outcomes

et al. 2017

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BackgroundPostoperative respiratory complications (PRCs) are associated with significant morbidity, mortality, and hospital costs. Obstructive sleep apnea (OSA), often undiagnosed in the surgical population, may be a contributing factor. Thus, we aimed to develop and validate a score for preoperative prediction of OSA (SPOSA) based on data available in electronic medical records preoperatively.MethodsOSA was defined as the occurrence of an OSA diagnostic code preceded by a polysomnography procedure. A priori defined variables were analyzed by multivariable logistic regression analysis to develop our score. Score validity was assessed by investigating the score’s ability to predict non-invasive ventilation. We then assessed the effect of high OSA risk, as defined by SPOSA, on PRCs within seven postoperative days and in-hospital mortality.ResultsA total of 108,781 surgical patients at Partners HealthCare hospitals (2007–2014) were studied. Predictors of OSA included BMI >25 kg*m−2 and comorbidities, including pulmonary hypertension, hypertension, and diabetes. The score yielded an area under the curve of 0.82. Non-invasive ventilation was significantly associated with high OSA risk (OR 1.44, 95% CI 1.22–1.69). Using a dichotomized endpoint, 26,968 (24.8%) patients were identified as high risk for OSA and 7.9% of these patients experienced PRCs. OSA risk was significantly associated with PRCs (OR 1.30, 95% CI 1.19–1.43).ConclusionSPOSA identifies patients at high risk for OSA using electronic medical record-derived data. High risk of OSA is associated with the occurrence of PRCs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-017-0361-z) contains supplementary material, which is available to authorized users.

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Elevated low-density lipoprotein cholesterol is independently associated with obstructive sleep apnea: evidence from a large-scale cross-sectional study

Abstract: We demonstrated that patients with OSA had a higher percentage of dyslipidemia than subjects without OSA. Of the various components in serum lipid, only LDL-C was independently associated with OSA.

Cited by 43 publications

References 32 publications

Smoking, obstructive sleep apnea syndrome and their combined effects on metabolic parameters: Evidence from a large cross-sectional study

Smoking, obstructive sleep apnea syndrome and their combined effects on metabolic parameters: Evidence from a large cross-sectional study

Interrelationships among common predictors of cardiovascular diseases in patients of OSA: A large-scale observational study

Development and validation of a Score for Preoperative Prediction of Obstructive Sleep Apnea (SPOSA) and its perioperative outcomes

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