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. 2024 Jul 4;23(1):209.
doi: 10.1186/s12944-024-02195-w.

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and obstructive sleep apnea: a cross-sectional study from NHANES

Xue Pan  1 , Xinyue Zhang  1 , Xinyi Wu  1 , Yue Zhao  1 , Yilong Li  1 , Zitong Chen  1 , Yue Hu  1 , Xuezhao Cao  2
Affiliations

Association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and obstructive sleep apnea: a cross-sectional study from NHANES

Xue Pan et al. Lipids Health Dis. .

Abstract

Background: Obstructive Sleep Apnea (OSA) is a widespread sleep disturbance linked to metabolic and cardiovascular conditions. The Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratios (NHHR) has been proposed as being a potential biomarker to gauge cardiovascular risk. However, its relationship with OSA remains unclear.

Methods: This survey investigated the link NHHR to OSA in American citizens aged 20 and older using information collected via the National Health and Nutrition Examination Survey (NHANES) during the years 2017 to 2020. Logistic regression models with multivariable adjustments were employed to assess this relationship. Nonlinear associations were explored using smooth curve fitting, with a two-part linear regression model identifying a threshold effect. Subgroup analyses were conducted to evaluate population-specific differences.

Results: The survey encompassed 6763 participants, with an average age of 50.75 ± 17.32. The average NHHR stood at 2.74, accompanied by a standard deviation of 1.34, while the average frequency of OSA was 49.93%. Upon adjusting for covariates, each unit increase in NHHR may be associated with a 9% rise in OSA incidence. (95% confidence intervals 1.04-1.14; P < 0.0001). Notably, a U-shaped curve depicted the NHHR-OSA relationship, with an inflection point at 4.12. Subgroup analyses revealed consistent associations, with educational attainment and diabetes status modifying the NHHR-OSA relationship.

Conclusion: The study highlights NHHR as a potential tool for OSA prediction, presenting avenues for advanced risk evaluation, tailored interventions, personalized treatment approaches, and preventive healthcare.

Keywords: NHANES; NHHR; Obesity; Obstructive sleep apnea.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of participant selection. HDL, High-Density Lipoprotein Cholesterol; TC, Total Cholesterol
Fig. 2
Fig. 2
Smoothed curve fit between NHHR and OSA The blue bars show the fitted 95% confidence intervals (95% CI) and the fitted smoothed curves are shown in red. OSA, Obstructive Sleep Apnea; NHHR, Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio
Fig. 3
Fig. 3
ROC curve between OSA and NHHR. ROC, Receiver Operating Characteristic; OSA, Obstructive Sleep Apnea; NHHR, Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio; HDL, High-Density Lipoprotein Cholesterol; TC, Total Cholesterol
See this image and copyright information in PMC

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