Wojciech Trzepizur1, Marc Le Vaillant2, Nicole Meslier1, Thierry Pigeanne3, Philippe Masson4, Marie P Humeau5, Acya Bizieux-Thaminy6, François Goupil7, Sylvaine Chollet8, Pierre H Ducluzeau9, Frédéric Gagnadoux10. 1. LUNAM University, Angers, France; Department of Respiratory Diseases, Angers University Hospital, Angers, France; INSERM U1063, Angers, France. 2. CERMES, CNRS UMR8211-INSERM U988-EHESS, Villejuif, France. 3. Department of Respiratory Diseases, Pôle santé des Olonnes, Olonnes sur Mer, France. 4. Department of Respiratory Diseases, Cholet Hospital, Cholet, France. 5. Department of Respiratory Diseases, Nouvelles Cliniques Nantaises, Nantes, France. 6. Department of Respiratory Diseases, La Roche sur Yon Hospital, La Roche sur Yon, France. 7. Department of Respiratory Diseases, Le Mans Hospital, Le Mans, France. 8. Department of Respiratory Diseases, Nantes University Hospital, Nantes, France. 9. LUNAM University, Angers, France; Department of Respiratory Diseases, Angers University Hospital, Angers, France; Department of Endocrinology-Diabetology-Nutrition, Angers University Hospital, Angers, France. 10. LUNAM University, Angers, France; Department of Respiratory Diseases, Angers University Hospital, Angers, France; INSERM U1063, Angers, France. Electronic address: frgagnadoux@chu-angers.fr.
Abstract
BACKGROUND: There is growing evidence from animal models that intermittent hypoxemia (IH) may induce dyslipidemia. Altered lipid metabolism may contribute to the increased cardiovascular risk observed in obstructive sleep apnea (OSA). In this multisite, cross-sectional study, we tested the hypothesis that there is an independent association between nocturnal IH and dyslipidemia in OSA. METHODS: Fasting serum lipid levels were measured in 2,081 patients (638 women) undergoing nocturnal recording for clinical suspicion of OSA. Multivariate regression analyses were performed to evaluate the independent associations between oxygen desaturation index (ODI) and lipid profile after adjustment for potential confounders, including components of the metabolic syndrome (MS) or the MS itself. Adjusted OR for metabolic dyslipidemia (triglycerides [TG] ≥ 150 mg/dL and high-density lipoprotein cholesterol [HDL-C] ≤ 50 mg/dL for women and ≤ 40 mg/dL for men) according to quartiles of ODI were determined by logistic regression. RESULTS: Total cholesterol and low-density lipoprotein cholesterol were not associated with ODI. In contrast, nocturnal IH and OSA severity were associated with higher TG levels and lower HDL-C levels after adjustment for confounding factors. The association between ODI and TG and HDL-C levels was independent of the MS. Adjusted OR (95% CIs) for metabolic dyslipidemia were 1 (reference), 1.56 (1.24-1.96), 1.72 (1.29-2.29), and 1.93 (1.55-2.41) for ODI ≤ 7, > 7 to ≤ 18, > 18 to ≤ 38, and > 38, respectively (P < .0001 for linear trend). CONCLUSIONS: Nocturnal IH is independently associated with metabolic dyslipidemia, which may predispose patients with OSA to a higher risk of cardiovascular disease.
BACKGROUND: There is growing evidence from animal models that intermittent hypoxemia (IH) may induce dyslipidemia. Altered lipid metabolism may contribute to the increased cardiovascular risk observed in obstructive sleep apnea (OSA). In this multisite, cross-sectional study, we tested the hypothesis that there is an independent association between nocturnal IH and dyslipidemia in OSA. METHODS: Fasting serum lipid levels were measured in 2,081 patients (638 women) undergoing nocturnal recording for clinical suspicion of OSA. Multivariate regression analyses were performed to evaluate the independent associations between oxygen desaturation index (ODI) and lipid profile after adjustment for potential confounders, including components of the metabolic syndrome (MS) or the MS itself. Adjusted OR for metabolic dyslipidemia (triglycerides [TG] ≥ 150 mg/dL and high-density lipoprotein cholesterol [HDL-C] ≤ 50 mg/dL for women and ≤ 40 mg/dL for men) according to quartiles of ODI were determined by logistic regression. RESULTS: Total cholesterol and low-density lipoprotein cholesterol were not associated with ODI. In contrast, nocturnal IH and OSA severity were associated with higher TG levels and lower HDL-C levels after adjustment for confounding factors. The association between ODI and TG and HDL-C levels was independent of the MS. Adjusted OR (95% CIs) for metabolic dyslipidemia were 1 (reference), 1.56 (1.24-1.96), 1.72 (1.29-2.29), and 1.93 (1.55-2.41) for ODI ≤ 7, &gt; 7 to ≤ 18, &gt; 18 to ≤ 38, and &gt; 38, respectively (P &lt; .0001 for linear trend). CONCLUSIONS:Nocturnal IH is independently associated with metabolic dyslipidemia, which may predispose patients with OSA to a higher risk of cardiovascular disease.
Authors: Marta Torres; Ricardo Laguna-Barraza; Mireia Dalmases; Alexandra Calle; Eva Pericuesta; Josep M Montserrat; Daniel Navajas; Alfonso Gutierrez-Adan; Ramon Farré Journal: Sleep Date: 2014-11-01 Impact factor: 5.849
Authors: Luciano F Drager; Vsevolod Y Polotsky; Christopher P O'Donnell; Sergio L Cravo; Geraldo Lorenzi-Filho; Benedito H Machado Journal: Am J Physiol Heart Circ Physiol Date: 2015-07-31 Impact factor: 4.733
Authors: Mireia Dalmases; Marta Torres; Leonardo Márquez-Kisinousky; Isaac Almendros; Anna M Planas; Cristina Embid; Miguel Ángel Martínez-Garcia; Daniel Navajas; Ramon Farré; Josep Maria Montserrat Journal: Sleep Date: 2014-07-01 Impact factor: 5.849