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

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Background

Lipid metabolism disorder is recognized to be associated with obstructive sleep apnea (OSA); however, inconsistent results have been reported. The aim of this study was to evaluate the association between lipid profile and OSA with adjustments for multiple confounding factors.

Methods

In total, 2983 subjects were recruited from the Shanghai Sleep Health Study (SSHS) during 2007–2013. Data for overnight polysomnography (PSG) parameters, serum lipids, fasting blood glucose, insulin levels, and anthropometric measurements were collected. Multivariable logistic regression analyses were used to determine the correlation between lipid profile and OSA with adjustments for confounders including lipids, age, gender, Epworth sleepiness scale, body mass index, waist/hip ratio, glucose, insulin resistance, hypertension, and smoking.

Results

The prevalence of hyper total cholesterol (TC), hyper triglycerides, hypo high-density lipoprotein cholesterol, hyper low-density lipoprotein cholesterol (LDL-C), hyper apolipoprotein (apo) A-I, and hyper apoB differed significantly between the non-OSA and OSA patients. Without considering the interaction across different lipids, TC, LDL-C, and apoB were independently associated with OSA in primary multivariable logistic regression analyses; the odds ratios (ORs) and 95 % confidence intervals (CIs) were 1.262 (1.109–1.438), 1.432 (1.233–1.664), and 5.582 (2.643–11.787), respectively. However, only LDL-C (OR = 1.430, 95 % CI = 1.221–1.675) was found to be an independent risk factor for OSA in further multivariable logistic regression analyses.

Conclusions

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.

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Acknowledgments

The Shanghai Sleep Health Study Research Group includes Huajun Xu, Jian Guan, Hongliang Yi, Jianyin Zou, Lili Meng, Xulan Tang, Huaming Zhu, Dongzhen Yu, Huiqun Zhou, Kaiming Su, Yue Wang, Jian Wang, and Shankai Yin.

Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233, China

    Huajun Xu, Jian Guan, Hongliang Yi, Lili Meng, Xulan Tang, Huaming Zhu, Dongzhen Yu, Huiqun Zhou, Kaiming Su & Shankai Yin

  2. Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China

    Huajun Xu, Jian Guan, Hongliang Yi, Jianyin Zou, Dongzhen Yu, Kaiming Su & Shankai Yin

  3. The Center for Disease Control and Prevention of China, Beijing, China

    Yue Wang

  4. School of Human Communication Disorders, Dalhousie University, Halifax, Canada

    Jian Wang

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  1. Huajun Xu
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  2. Jian Guan
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The Shanghai Sleep Health Study Research Group

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Correspondence to Jian Guan.

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Xu, H., Guan, J., Yi, H. et al. Elevated low-density lipoprotein cholesterol is independently associated with obstructive sleep apnea: evidence from a large-scale cross-sectional study. Sleep Breath 20, 627–634 (2016). https://doi.org/10.1007/s11325-015-1262-3

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  • DOI: https://doi.org/10.1007/s11325-015-1262-3

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