title: Minimal nocturnal oxygen saturation predicts future subclinical carotid atherosclerosis: the Wisconsin sleep cohort.
abstract: Previous data on the associations between nocturnal oxygen saturation parameters and carotid atherosclerosis are conflicting. We examined the prospective associations of nocturnal oxygen saturation (SaO2 ) and cardiovascular disease (CVD) risk factors with carotid intima-media thickness (IMT) and plaques. We used data on 689 Wisconsin sleep cohort participants who had baseline overnight polysomnography followed by carotid ultrasonography a mean (SD) of 7.8 (2.5) years later. Far wall common carotid IMT was measured using B-mode ultrasound. Bilateral common, bifurcation and internal carotid artery segments were evaluated for plaque score. Participants (8) were aged 56 years (55% male); 32% had hypertension and mean body mass index (BMI) was 31 (7) kg m(2). Mean and minimum nocturnal SaO2 were 95% (2) and 86% (7), respectively. Mean percentage sleep time with SaO2 < 90% was 2% (8). Both mean (odds ratio [OR]: 0.60 lower plaque count per 5% higher mean SaO2, 95% confidence interval [CI]: 0.38-0.96, P = 0.033) and minimum SaO2 (OR: 0.88 lower plaque count per 5% higher minimum SaO2, 95% CI: 0.80-0.97, P = 0.013) predicted carotid plaque score after adjusting for age, sex and BMI. Minimum SaO2 predicted future plaque score after adding adjustment for traditional CVD risk factors (OR: 0.90 lower plaque count per 5% higher minimum SaO2, 95% CI: 0.81-0.99, P = 0.038). Mean SaO2 was not associated with carotid IMT after CVD risk factor adjustment. We conclude that minimum nocturnal SaO2 is an independent predictor of future carotid plaque burden. Other nocturnal SaO2 parameters are not associated with future carotid IMT or plaques after adjusting for traditional CVD risk factors.
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Sverrir I
authors.initials: SI
authors.lastname: Gunnarsson
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Peppard
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Korcarz
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Jodi H
authors.initials: JH
authors.lastname: Barnet
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Erika W
authors.initials: EW
authors.lastname: Hagen
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: K Mae
authors.initials: KM
authors.lastname: Hla
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Mari
authors.initials: M
authors.lastname: Palta
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Terry
authors.initials: T
authors.lastname: Young
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.|Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
mesh_terms: D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000378:metabolism*; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010100:Oxygen / Q000378:metabolism*; D058226:Plaque, Atherosclerotic / Q000378:metabolism; D017286:Polysomnography; D011446:Prospective Studies; D012890:Sleep; D013997:Time Factors; D014922:Wisconsin
chemical_list: D010100:Oxygen
keywords: carotid arteries; epidemiology; sleep apnea