title: Relation of obstructive sleep apnea to coronary artery calcium in non-obese versus obese men and women aged 45-75 years.
abstract: Sleep apnea and obesity are strongly associated, and both increase the risk for coronary artery disease. Several cross-sectional studies have reported discrepant results regarding the role obesity plays in the relation between sleep apnea and coronary artery calcium (CAC), a marker of subclinical coronary disease. The aim of the present study was to investigate the association between sleep apnea and the presence of CAC in a community cohort of middle-aged men and women without preexisting cardiovascular disease, stratified by body mass index (<30 vs ≥30 kg/m(2)). Participants underwent electron-beam computed tomography to measure CAC and underwent home sleep testing for sleep apnea. The presence of CAC was defined as an Agatston score >0. Sleep apnea was analyzed categorically using the apnea-hypopnea index. The sample was composed of primarily men (61%) and Caucasians (56%), with a mean age of 61 years. The prevalence of CAC was 76%. In participants with body mass indexes <30 kg/m(2) (n = 139), apnea-hypopnea index ≥15 (vs <5) was associated with 2.7-fold odds of having CAC, but the effect only approached significance. Conversely, in participants with body mass indexes ≥30 kg/m(2), sleep apnea was not independently associated with CAC. In conclusion, sleep apnea is independently associated with early atherosclerotic plaque burden in nonobese patients.
authors.affiliation: Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: luysterfs@upmc.edu.
authors.forename: Faith S
authors.initials: FS
authors.lastname: Luyster
authors.affiliation: College of Nursing, University of South Florida, Tampa, Florida.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.affiliation: Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Aryan N
authors.initials: AN
authors.lastname: Aiyer
authors.affiliation: Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Reis
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Strollo
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*