title: Independent association between nocturnal intermittent hypoxemia and metabolic dyslipidemia.
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, &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.affiliation: LUNAM University, Angers, France; Department of Respiratory Diseases, Angers University Hospital, Angers, France; INSERM U1063, Angers, France.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Trzepizur
authors.affiliation: CERMES, CNRS UMR8211-INSERM U988-EHESS, Villejuif, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Le Vaillant
authors.affiliation: LUNAM University, Angers, France; Department of Respiratory Diseases, Angers University Hospital, Angers, France; INSERM U1063, Angers, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Meslier
authors.affiliation: Department of Respiratory Diseases, Pôle santé des Olonnes, Olonnes sur Mer, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Pigeanne
authors.affiliation: Department of Respiratory Diseases, Cholet Hospital, Cholet, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Masson
authors.affiliation: Department of Respiratory Diseases, Nouvelles Cliniques Nantaises, Nantes, France.
authors.forename: Marie P
authors.initials: MP
authors.lastname: Humeau
authors.affiliation: Department of Respiratory Diseases, La Roche sur Yon Hospital, La Roche sur Yon, France.
authors.forename: Acya
authors.initials: A
authors.lastname: Bizieux-Thaminy
authors.affiliation: Department of Respiratory Diseases, Le Mans Hospital, Le Mans, France.
authors.forename: François
authors.initials: F
authors.lastname: Goupil
authors.affiliation: Department of Respiratory Diseases, Nantes University Hospital, Nantes, France.
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Chollet
authors.affiliation: LUNAM University, Angers, France; Department of Respiratory Diseases, Angers University Hospital, Angers, France; Department of Endocrinology-Diabetology-Nutrition, Angers University Hospital, Angers, France.
authors.forename: Pierre H
authors.initials: PH
authors.lastname: Ducluzeau
authors.affiliation: LUNAM University, Angers, France; Department of Respiratory Diseases, Angers University Hospital, Angers, France; INSERM U1063, Angers, France. Electronic address: frgagnadoux@chu-angers.fr.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gagnadoux
mesh_terms: D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*; D011795:Surveys and Questionnaires