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. 2024 May 18;25(1):214.
doi: 10.1186/s12931-024-02846-7.

Independent relationship between sleep apnea-specific hypoxic burden and glucolipid metabolism disorder: a cross-sectional study

Chenyang Li #  1   2 , Yu Peng #  1   2 , Xiaoyue Zhu #  1   2 , Yupu Liu  1   2 , Jianyin Zou  1   2 , Huaming Zhu  1   2 , Xinyi Li  1   2 , Hongliang Yi  1   2 , Jian Guan  3   4 , Xu Zhang  5 , Huajun Xu  6   7 , Shankai Yin  1   2
Affiliations

Independent relationship between sleep apnea-specific hypoxic burden and glucolipid metabolism disorder: a cross-sectional study

Chenyang Li et al. Respir Res. .

Abstract

Objectives: Obstructive sleep apnea (OSA) is associated with abnormal glucose and lipid metabolism. However, whether there is an independent association between Sleep Apnea-Specific Hypoxic Burden (SASHB) and glycolipid metabolism disorders in patients with OSA is unknown.

Methods: We enrolled 2,173 participants with suspected OSA from January 2019 to July 2023 in this study. Polysomnographic variables, biochemical indicators, and physical measurements were collected from each participant. Multiple linear regression analyses were used to evaluate independent associations between SASHB, AHI, CT90 and glucose as well as lipid profile. Furthermore, logistic regressions were used to determine the odds ratios (ORs) for abnormal glucose and lipid metabolism across various SASHB, AHI, CT90 quartiles.

Results: The SASHB was independently associated with fasting blood glucose (FBG) (β = 0.058, P = 0.016), fasting insulin (FIN) (β = 0.073, P < 0.001), homeostasis model assessment of insulin resistance (HOMA-IR) (β = 0.058, P = 0.011), total cholesterol (TC) (β = 0.100, P < 0.001), total triglycerides (TG) (β = 0.063, P = 0.011), low-density lipoprotein cholesterol (LDL-C) (β = 0.075, P = 0.003), apolipoprotein A-I (apoA-I) (β = 0.051, P = 0.049), apolipoprotein B (apoB) (β = 0.136, P < 0.001), apolipoprotein E (apoE) (β = 0.088, P < 0.001) after adjustments for confounding factors. Furthermore, the ORs for hyperinsulinemia across the higher SASHB quartiles were 1.527, 1.545, and 2.024 respectively, compared with the lowest quartile (P < 0.001 for a linear trend); the ORs for hyper-total cholesterolemia across the higher SASHB quartiles were 1.762, 1.998, and 2.708, compared with the lowest quartile (P < 0.001 for a linear trend) and the ORs for hyper-LDL cholesterolemia across the higher SASHB quartiles were 1.663, 1.695, and 2.316, compared with the lowest quartile (P < 0.001 for a linear trend). Notably, the ORs for hyper-triglyceridemia{1.471, 1.773, 2.099} and abnormal HOMA-IR{1.510, 1.492, 1.937} maintained a consistent trend across the SASHB quartiles.

Conclusions: We found SASHB was independently associated with hyperinsulinemia, abnormal HOMA-IR, hyper-total cholesterolemia, hyper-triglyceridemia and hyper-LDL cholesterolemia in Chinese Han population. Further prospective studies are needed to confirm that SASHB can be used as a predictor of abnormal glycolipid metabolism disorders in patients with OSA.

Trial registration: ChiCTR1900025714 { http://www.chictr.org.cn/ }; Prospectively registered on 6 September 2019; China.

Keywords: Abnormal glucose and lipid metabolism.; Obstructive sleep apnea hypopnea syndrome; Sleep apnea-specific hypoxic burden.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Screening flow chat of participants
Fig. 2
Fig. 2
Calculation of SASHB for individual respiratory events corresponding to specific search window
Fig. 3
Fig. 3
Adjusted mean values of the glucose and lipid levels in model 1. (a) FBG - SASHB; (b) FIN - SASHB; (c) HOMA-IR - SASHB; (d) TC - SASHB; (e) TG - SASHB; (f) HDL - SASHB; (g) LDL - SASHB; (h) apoA-I - SASHB; (i) apoB - SASHB; and (j) apoE - SASHB. Abbreviations: The data were adjusted for age, body mass index (BMI), and sex. FBG: Fasting blood glucose; FIN: Fasting insulin; HOMA-IR: Homeostasis model assessment of insulin resistance; TC: Total cholesterol; TG: Total triglycerides; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; apoA-I: apolipoprotein A-I; apoB: apolipoprotein B; apoE: apolipoprotein E; SASHB: Sleep Apnea-Specific Hypoxic Burden
Fig. 4
Fig. 4
Adjusted mean values of the glucose and lipid levels in model 2. (a) FBG - SASHB; (b) FIN - SASHB; (c) HOMA-IR - SASHB; (d) TC - SASHB; (e) TG - SASHB; (f) HDL - SASHB; (g) LDL - SASHB; (h) apoA-I - SASHB; (i) apoB - SASHB; and (j) apoE - SASHB. Abbreviations: The data were adjusted for age, body mass index (BMI), sex, smoking status, mean artery pressure, and alcohol consumption. FBG: Fasting blood glucose; FIN: Fasting insulin; HOMA-IR: Homeostasis model assessment of insulin resistance; TC: Total cholesterol; TG: Total triglycerides; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; apoA-I: apolipoprotein A-I; apoB: apolipoprotein B; apoE: apolipoprotein E; SASHB: Sleep Apnea-Specific Hypoxic Burden
Fig. 5
Fig. 5
Adjusted mean values of the glucose and lipid levels in model 3. (a) FBG - SASHB; (b) FIN - SASHB; (c) HOMA-IR - SASHB; (d) TC - SASHB; (e) TG - SASHB; (f) HDL - SASHB; (g) LDL - SASHB; (h) apoA-I - SASHB; (i) apoB - SASHB; and (j) apoE - SASHB. Abbreviations: The data were adjusted for age, body mass index (BMI), sex, smoking status, mean artery pressure, alcohol consumption and microarousal index. FBG: Fasting blood glucose; FIN: Fasting insulin; HOMA-IR: Homeostasis model assessment of insulin resistance; TC: Total cholesterol; TG: Total triglycerides; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; apoA-I: apolipoprotein A-I; apoB: apolipoprotein B; apoE: apolipoprotein E; SASHB: Sleep Apnea-Specific Hypoxic Burden
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