Obstructive sleep apnoea/hypopnea influences high-density lipoprotein cholesterol in the elderly

Sleep Med. 2009 Sep;10(8):882-6. doi: 10.1016/j.sleep.2008.07.017. Epub 2009 Feb 5.

Abstract

Background and purpose: An association between obstructive sleep apnoea/hypopnea (OSAH) and cardiovascular risk factors such as dyslipidemia has been described in adults and high-risk populations.

Patients and methods: We examined this association in a prospective cohort (SYNAPSE study) of 846 elderly (68.5+/-1.1 years) volunteers (41.6% of men). No subject presented with recognized OSAH syndrome, heart disease, or any neurological disorder. Unattended at-home polygraphy was done by all subjects. OSAH severity was defined as moderate (apnoea/hypopnea index: AHI>15/h) or severe (AHI>30/h). High-density lipoprotein cholesterol (HDL-c) was measured by immuno-separation-based homogenous assay.

Results: The prevalence of severe cases reached 21.5% (AHI mean+/-SD: 43.5+/-11.9). Using univariate linear regression analysis, AHI (R=-0.172; p<0.0001), oxyhemoglobin desaturation index (ODI) (R=-0.108; p<0.002), mean SaO(2) (R=0.125; p<0.0003) and Nadir SaO(2) (R=0.094; p<0.007) were significantly associated with HDL-c. Multiple regression analysis demonstrated that male gender, BMI, waist to hip ratio, ODI, and AHI represent independent predictors of HDL-c. Logistic regression analysis showed a significant association between severe OSAH and low HDL-c serum levels (p<0.03) after adjustment for gender, BMI, hypertension, glycaemia, waist to hip ratio, alcohol intake and treated dyslipidemia. The association appears more evident in subjects free of lipid-lowering medications and beta-blockers (p<0.007). There was no independent association of OSAH syndrome with low-density lipoprotein (LDL) cholesterol.

Conclusion: Unrecognized moderate to severe apnoea/hypopnea syndrome was independently associated with low HDL-c serum levels in the present cross-sectional based elderly population. This could explain the deleterious effect of OSAH syndrome on cardiovascular risk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aging / metabolism
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / metabolism*
  • Cholesterol, HDL / blood*
  • Cholesterol, LDL / blood
  • Cohort Studies
  • Dyslipidemias / epidemiology
  • Dyslipidemias / metabolism
  • Female
  • Humans
  • Linear Models
  • Male
  • Prevalence
  • Risk Factors
  • Sleep Apnea Syndromes / epidemiology
  • Sleep Apnea Syndromes / metabolism
  • Sleep Apnea, Obstructive / epidemiology*
  • Sleep Apnea, Obstructive / metabolism*

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL