title: Elevated low-density lipoprotein cholesterol is independently associated with obstructive sleep apnea: evidence from a large-scale cross-sectional study.
abstract: BACKGROUND
  Lipid metabolism disorder is recognized to be associated with obstructive sleep apnea (OSA); however, inconsistent results have been reported. The aim of this study was to evaluate the association between lipid profile and OSA with adjustments for multiple confounding factors.
  
  
  METHODS
  In total, 2983 subjects were recruited from the Shanghai Sleep Health Study (SSHS) during 2007-2013. Data for overnight polysomnography (PSG) parameters, serum lipids, fasting blood glucose, insulin levels, and anthropometric measurements were collected. Multivariable logistic regression analyses were used to determine the correlation between lipid profile and OSA with adjustments for confounders including lipids, age, gender, Epworth sleepiness scale, body mass index, waist/hip ratio, glucose, insulin resistance, hypertension, and smoking.
  
  
  RESULTS
  The prevalence of hyper total cholesterol (TC), hyper triglycerides, hypo high-density lipoprotein cholesterol, hyper low-density lipoprotein cholesterol (LDL-C), hyper apolipoprotein (apo) A-I, and hyper apoB differed significantly between the non-OSA and OSA patients. Without considering the interaction across different lipids, TC, LDL-C, and apoB were independently associated with OSA in primary multivariable logistic regression analyses; the odds ratios (ORs) and 95 % confidence intervals (CIs) were 1.262 (1.109-1.438), 1.432 (1.233-1.664), and 5.582 (2.643-11.787), respectively. However, only LDL-C (OR = 1.430, 95 % CI = 1.221-1.675) was found to be an independent risk factor for OSA in further multivariable logistic regression analyses.
  
  
  CONCLUSIONS
  We demonstrated that patients with OSA had a higher percentage of dyslipidemia than subjects without OSA. Of the various components in serum lipid, only LDL-C was independently associated with OSA.
authors.affiliation: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.|Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Huajun
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China. guanjian0606@sina.com.|Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China. guanjian0606@sina.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Guan
authors.affiliation: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.|Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Yi
authors.affiliation: Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Jianyin
authors.initials: J
authors.lastname: Zou
authors.affiliation: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Meng
authors.affiliation: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
authors.forename: Xulan
authors.initials: X
authors.lastname: Tang
authors.affiliation: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
authors.forename: Huaming
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.|Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Dongzhen
authors.initials: D
authors.lastname: Yu
authors.affiliation: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
authors.forename: Huiqun
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.|Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Kaiming
authors.initials: K
authors.lastname: Su
authors.affiliation: The Center for Disease Control and Prevention of China, Beijing, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Wang
authors.affiliation: School of Human Communication Disorders, Dalhousie University, Halifax, Canada.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.|Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Shankai
authors.initials: S
authors.lastname: Yin
mesh_terms: D000328:Adult; D000368:Aged; D016632:Apolipoprotein A-I / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D002681:China; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D015228:Hypertriglyceridemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D013223:Statistics as Topic
chemical_list: D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D008078:Cholesterol, LDL
keywords: Dyslipidemia; Lipids; Obesity; Obstructive sleep apnea