Obstructive sleep apnoea independently predicts lipid levels: Data from the European Sleep Apnea Database
Canan Gündüz
Department of Chest Diseases, Ege University, Izmir, Turkey
Search for more papers by this authorOzen K. Basoglu
Department of Chest Diseases, Ege University, Izmir, Turkey
Search for more papers by this authorJan Hedner
Sleep and Vigilance Laboratory, Sahlgrenska Academy, Gothenburg, Sweden
Search for more papers by this authorDing Zou
Sleep and Vigilance Laboratory, Sahlgrenska Academy, Gothenburg, Sweden
Search for more papers by this authorMaria R. Bonsignore
Biomedical Department of Internal and Specialist Medicine (DiBiMIS), Section of Pneumology, University of Palermo, Palermo, Italy
CNR Institute of Biomedicine and Molecular Immunology, Palermo, Italy
Search for more papers by this authorRichard Staats
Department of Respiratory Medicine, Hospital de Santa Maria, Lisbon, Portugal
Search for more papers by this authorAthanasia Pataka
Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki, Greece
Search for more papers by this authorFerran Barbe
Servei Pneumologia Hospital Arnau de Vilanova and Hospital Santa Maria, Lleida, Spain
CIBERes, Madrid, Spain
Search for more papers by this authorPavel Sliwinski
2nd Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
Search for more papers by this authorBrian D. Kent
Sleep Disorders Centre, Guy's and St Thomas' Hospitals, London, UK
Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
Search for more papers by this authorCorresponding Author
Ludger Grote
Sleep and Vigilance Laboratory, Sahlgrenska Academy, Gothenburg, Sweden
Correspondence: Ludger Grote, Sleep and Vigilance Laboratory, Sahlgrenska Academy, Gothenburg University, ESADA Office, Medicinaregatan 8B, 413 90 Gothenburg, Sweden. Email: [email protected]Search for more papers by this authoron behalf of the European Sleep Apnea Database Collaborators
For a list of the ESADA collaborators and their affiliations, see Appendix S1 (Supplementary Information).Search for more papers by this authorCanan Gündüz
Department of Chest Diseases, Ege University, Izmir, Turkey
Search for more papers by this authorOzen K. Basoglu
Department of Chest Diseases, Ege University, Izmir, Turkey
Search for more papers by this authorJan Hedner
Sleep and Vigilance Laboratory, Sahlgrenska Academy, Gothenburg, Sweden
Search for more papers by this authorDing Zou
Sleep and Vigilance Laboratory, Sahlgrenska Academy, Gothenburg, Sweden
Search for more papers by this authorMaria R. Bonsignore
Biomedical Department of Internal and Specialist Medicine (DiBiMIS), Section of Pneumology, University of Palermo, Palermo, Italy
CNR Institute of Biomedicine and Molecular Immunology, Palermo, Italy
Search for more papers by this authorRichard Staats
Department of Respiratory Medicine, Hospital de Santa Maria, Lisbon, Portugal
Search for more papers by this authorAthanasia Pataka
Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki, Greece
Search for more papers by this authorFerran Barbe
Servei Pneumologia Hospital Arnau de Vilanova and Hospital Santa Maria, Lleida, Spain
CIBERes, Madrid, Spain
Search for more papers by this authorPavel Sliwinski
2nd Department of Respiratory Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
Search for more papers by this authorBrian D. Kent
Sleep Disorders Centre, Guy's and St Thomas' Hospitals, London, UK
Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
Search for more papers by this authorCorresponding Author
Ludger Grote
Sleep and Vigilance Laboratory, Sahlgrenska Academy, Gothenburg, Sweden
Correspondence: Ludger Grote, Sleep and Vigilance Laboratory, Sahlgrenska Academy, Gothenburg University, ESADA Office, Medicinaregatan 8B, 413 90 Gothenburg, Sweden. Email: [email protected]Search for more papers by this authoron behalf of the European Sleep Apnea Database Collaborators
For a list of the ESADA collaborators and their affiliations, see Appendix S1 (Supplementary Information).Search for more papers by this authorABSTRACT
Background and objective
Obstructive sleep apnoea (OSA) and dyslipidaemia are independent risk factors for cardiovascular disease. This study investigates the association between OSA and plasma lipid concentrations in patients enrolled in the European Sleep Apnea Database (ESADA) cohort.
Methods
The cross-sectional analysis included 8592 patients without physician-diagnosed hyperlipidaemia or reported intake of a lipid-lowering drug (age 50.1 ± 12.7 years, 69.1% male, BMI: 30.8 ± 6.6 kg/m2, mean apnoea–hypopnoea index (AHI): 25.7 ± 25.9 events/h). The independent relationship between measures of OSA (AHI, oxygen desaturation index (ODI), mean and lowest oxygen saturation) and lipid profile (total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and fasting triglycerides (TG)) was determined by means of general linear model analysis.
Results
There was a dose response relationship between TC and ODI (mean ± SE (mg/dL): 180.33 ± 2.46, 184.59 ± 2.42, 185.44 ± 2.42 and 185.73 ± 2.44; P < 0.001 across ODI quartiles I–IV). TG and LDL concentrations were better predicted by AHI than by ODI. HDL-C was significantly reduced in the highest AHI quartile (mean ± SE (mg/dL): 48.8 ± 1.49 vs 46.50 ± 1.48; P = 0.002, AHI quartile I vs IV). Morbid obesity was associated with lower TC and higher HDL-C values. Lipid status was influenced by geographical location with the highest TC concentration recorded in Northern Europe.
Conclusion
OSA severity was independently associated with cholesterol and TG concentrations.
Supporting Information
| Filename | Description |
|---|---|
| resp13372-sup-0001-Appendix.docxWord 2007 document , 904.6 KB |
Appendix S1 Collaborators in the ESADA project (alphabetical order). Appendix S2 Supplementary methods. Figure S1 Mean concentration of TC in European Regions within the ESADA study. Figure S2 Adjusted means of cholesterol in relation to quartiles of ODI, mean SaO2 and lowest SpO2. Figure S3 Adjusted means of HDL-C in relation to quartiles of ODI, mean SpO2 and lowest SpO2. Figure S4 Adjusted means of LDL-C in relation to quartiles of ODI, mean SpO2 and lowest SpO2. Figure S5 Adjusted means of TG in relation to quartiles of ODI, mean SpO2 and lowest SpO2. Table S1 Univariate correlations of cholesterol with demographic, clinical and anthropomorphic factors, indices of OSA and nocturnal hypoxaemia. Table S2 Proportions of polysomnography and polygraphy in European Regions. Table S3 Anthropometric data of subjects examined with polygraphy. Table S4 Anthropometric data of subjects examined with polysomnography. Table S5 Independent predictors of TC levels in subjects examined with polygraphy. Table S6 Independent predictors of TC in subjects examined with polysomnography. Table S7 Adjusted OR of TC level ≥ 200 mg/dL across quartiles of OSA syndrome severity and oxygenation indices. Table S8 Univariate correlations of HDL-C with demographic, clinical and anthropomorphic factors, and indices of OSA syndrome severity and nocturnal hypoxaemia. Table S9 Adjusted OR of HDL level < 40 mg/dL across quartiles of OSA syndrome severity and oxygenation indices. Table S10 Univariate correlations of LDL-C with demographic, clinical and anthropomorphic factors, and indices of OSA syndrome severity and nocturnal hypoxaemia. Table S11 Adjusted OR of LDL-C level ≥ 100 mg/dL across quartiles of OSA syndrome severity and oxygenation indices. Table S12 Univariate correlations of TG with demographic, clinical and anthropomorphic factors, and indices of OSA syndrome severity and nocturnal hypoxaemia. Table S13 Adjusted OR of TG level ≥ 150 mg/dL across quartiles of OSA syndrome severity and oxygenation indices. Table S14 The classification of European regions and ESADA study centres. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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