title: Interaction between Obstructive Sleep Apnea and Shortened Telomere Length on Brain White Matter Abnormality.
abstract: Age-related brain white matter changes (WMC) have been associated separately with obstructive sleep apnea (OSA) and short telomere length (TL). No studies have examined their interaction effect on WMC.
  
  
  
  This is a cross-sectional study with a community-based sample of 420 participants (mean age, 61.3 ± 7.2) from the Korean Genome and Epidemiology Study during 2011-2012. An overnight fasted blood sample was taken to determine glucose and blood lipid levels at the sleep laboratory of Korea University Ansan Hospital. The status of brain WMC was determined using structural magnetic resonance imaging at 1.5 Tesla. Overnight polysomnography was performed, and leukocyte TL was measured. OSA was determined based on apnea-hypopnea index, and short TL was defined as the lowest quartile of the study participants.
  
  
  
  Adjusting for age, sex, BMI, smoking, drinking, snoring, and hypertension, odds ratio (OR) of brain WMC was estimated using multivariate logistic regression. The odds ratio was significant for cardiovascular disease (OR, 4.5; 95% CI, 1.2-16.3) and OSA (OR, 4.0; 95% CI, 1.0-15.2) among those with short TL; and for diabetes (OR, 3.0; 95% CI, 1.3-13.0) and age (OR, 1.1; 95% CI, 1.0-1.1) among those with longer TL. Interaction effect of OSA and short TL (OR, 4.3; 95% CI, 1.4-13.8) was significant, compared to those with neither OSA nor short TL.
  
  
  
  This study provides a first evidence of mediated interaction of short TL with OSA on brain WMC in a community-based sample. The results generate new hypotheses regarding mechanisms of impaired brain health in sleep apnea.
authors.affiliation: Korea University Ansan Hospital, Institute of Human Genomic Study, Korea.
authors.forename: Kyung-Mee
authors.initials: KM
authors.lastname: Choi
authors.affiliation: Division of Pulmonary Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Thomas
authors.affiliation: Korea University Ansan Hospital, Institute of Human Genomic Study, Korea.
authors.forename: Dai Wui
authors.initials: DW
authors.lastname: Yoon
authors.affiliation: Korea University Ansan Hospital, Institute of Human Genomic Study, Korea.
authors.forename: Seung Ku
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Kookmin University, Foods and Nutrition, Korea.
authors.forename: Inkyung
authors.initials: I
authors.lastname: Baik
authors.affiliation: Korea University Ansan Hospital, Institute of Human Genomic Study, Korea.|Korea University Ansan Hospital, Internal Medicine, Division of Sleep and Critical Care Medicine, Korea.
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005819:Genetic Markers; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017286:Polysomnography; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000235:genetics* / Q000473:pathology* / Q000503:physiopathology; D016615:Telomere / Q000473:pathology*; D066127:White Matter / Q000473:pathology*
chemical_list: D005819:Genetic Markers
keywords: brain white matter changes; sleep-disordered breathing; telomere shortening