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[Online ahead of print]

Association Between Obstructive Sleep Apnea and Lipid Metabolism During REM and NREM Sleep

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Association Between Obstructive Sleep Apnea and Lipid Metabolism During REM and NREM Sleep

Huajun Xu et al. J Clin Sleep Med.

Abstract

Background: Obstructive sleep apnea (OSA) is thought to be associated with dyslipidemia. However, differences concerning dyslipidemia during rapid eye movement (REM) and non-REM (NREM) sleep have yet to be determined.

Objectives: This study was designed to explore the association between lipid profiles and OSA during REM or NREM sleep.

Methods: This is a clinical cohort. A total of 2,619 participants with at least 30 min of REM sleep were included. Sleep variables and fasting lipid profiles [total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein (apo)A-I, apoB, apoE, and lipoprotein(a) (Lp(a))] were obtained from each subject. Apnea-hypopnea indices (AHIs) in REM and NREM sleep (AHIREM and AHINREM, respectively) were recorded. Linear regression analysis was used to assess the associations of AHIREM and AHINREM with lipid profiles.

Results: When stratified by the AHIREM severity of OSA, all demographics, clinical variables, and sleep parameters differed between the groups except for apoA-I. In fully adjusted multivariate linear regression models, AHIREM was independently associated with increasing levels of TG, HDL-C, and apoE (p = 0.04, p = 0.01 and p = 0.01, respectively). AHINREM was independently associated with increasing levels of TC, TG, LDL and apoB, and lower level of HDL-C (all p < 0.05). In sensitivity analyses by only exploring associations in patients who had an AHINREM < 5 or AHIREM < 5 times per hour in separate regression models, AHIREM was not associated with all lipid profile in almost all adjusted models (all p > 0.05), while AHINREM was associated with elevated TC, LDL-C, and apoB (p = 0.03, p = 0.01 and p = 0.01, respectively).

Conclusion: AHINREM was independently associated with the greatest alterations in serum lipids, including TC, LDL-C, and apoB.

Keywords: Obstructive sleep apnea; dyslipidemia; lipid profile; rapid eye movement.

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