Obstructive sleep apnea and lipid abnormalities

Authors

  • Dimitar Karkinski University Clinic of Pulmology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje
  • Oliver Georgievski University Clinic of Clinical Biochemistry, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje
  • Pavlina Dzekova-Vidimliski University Clinic of Nephrology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje
  • Tatajana Milenkovic University Clinic of Endocrinology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje
  • Dejan Dokic University Clinic of Pulmology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje

DOI:

https://doi.org/10.3889/oamjms.2017.011

Keywords:

OSA, BMI, lipids

Abstract

BACKGROUND: There has been a great interest in the interaction between obstructive sleep apnea (OSA) and metabolic dysfunction, but there is no consistent data suggesting that OSA is a risk factor for dyslipidemia.

AIM: The aim of this cross-sectional study was to evaluate the prevalence of lipid abnormalities in patients suspected of OSA, referred to our sleep laboratory for polysomnography.

MATERIAL AND METHODS: Two hundred patients referred to our hospital with suspected OSA, and all of them underwent for standard polysomnography. All patients with respiratory disturbance index (RDI) above 15 were diagnosed with OSA. In the morning after 12 hours fasting, the blood sample was collected from all patients. Blood levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL), were determined in all study patients. In the study, both OSA positive and OSA negative patients were divided according to the body mass index (BMI) in two groups. The first group with BMI ≤ 30 kg/m^2 and the second group with BMI > 30 kg/m^2.

RESULTS: OSA positive patients with BMI ≤ 30 kg/m^2 had statistically significant higher levels of triglycerides and total cholesterol, and statistically significant lower level of HDL compared to OSA negative patients with BMI ≤ 30. There were no statistically significant differences in age and LDL levels between these groups. OSA positive patients with BMI > 30 kg/m^2 had higher levels of triglycerides, total cholesterol and LDL and lower levels of HDL versus OSA negative patients with BMI > 30 kg/m^2, but without statistically significant differences.

CONCLUSION:OSA and obesity are potent risk factors for dyslipidemias. OSA could play a significant role in worsening of lipid metabolism in non-obese patients. But in obese patients, the extra weight makes the metabolic changes of lipid metabolism, and the role of OSA is not that very important like in non-obese patients.

 

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230-5. https://doi.org/10.1056/NEJM199304293281704 PMid:8464434 DOI: https://doi.org/10.1056/NEJM199304293281704

Dempsey J, Veasey S, Morgan B, O'Donnel C. Pathophysiology of sleep apnea. Physiol Rev. 2010; 90: 47–112. https://doi.org/10.1152/physrev.00043.2008 PMid:20086074 PMCid:PMC3970937 DOI: https://doi.org/10.1152/physrev.00043.2008

Bradley TD, Floras JS. Obstructive sleep apnea and its cardiovascular consequences. Lancet. 2009;373: 82-93. https://doi.org/10.1016/S0140-6736(08)61622-0 DOI: https://doi.org/10.1016/S0140-6736(08)61622-0

Malhotra A, Loscalzo J. Sleep and cardiovascular disease: an overview. Prog Cardiovas Dis. 2009; 51:279-284. https://doi.org/10.1016/j.pcad.2008.10.004 PMid:19110129 PMCid:PMC2722952 DOI: https://doi.org/10.1016/j.pcad.2008.10.004

Drager LF, Jun J, Polotsky VY. Obstructive sleep apnea and dyslipidemia: implications for atherosclerosis. Curr Opin Endocrinol Diabetes Obes. 2010;17:161-5. Erratum in: Curr Opin Endocrinol Diabetes Obes. 2010;17:394. https://doi.org/10.1097/MED.0b013e3283373624 PMid:20125003 PMCid:PMC2904751 DOI: https://doi.org/10.1097/MED.0b013e3283373624

Togeiro SM, Carneiro G, Ribeiro Filho FF, et al. Consequences of Obstructive Sleep Apnea on Metabolic Profile: A Population-Based Survey. Obesity (Silver Spring). 2013;21:847-51. https://doi.org/10.1002/oby.20288 PMid:23712988 DOI: https://doi.org/10.1002/oby.20288

Coughlin SR, Mawdsley L, Mugarza JA, Calverley PM, Wilding JP. Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. Eur Heart J. 2004;25:735-41. https://doi.org/10.1016/j.ehj.2004.02.021 PMid:15120883 DOI: https://doi.org/10.1016/j.ehj.2004.02.021

Roche F, Sforza E, Pichot V, Maudoux D, Garcin A, Celle S, Picard-Kossovsky M, Gaspoz JM, Barthélémy JC; PROOF Study Group. Obstructive sleep apnoea/hypopnea influences high-density lipoprotein cholesterol in the elderly. Sleep Med. 2009;10:882-6. https://doi.org/10.1016/j.sleep.2008.07.017 PMid:19200781 DOI: https://doi.org/10.1016/j.sleep.2008.07.017

Newman AB, Nieto FJ, Guidry U, Lind BK, Redline S, Pickering TG, Quan SF; Sleep Heart Health Study Research Group. Relation of sleep-disordered breathing to cardiovascular disease risk factors: the Sleep Heart Health Study. Am J Epidemiol. 2001;154:50-9. https://doi.org/10.1093/aje/154.1.50

Drager LF, Lopes HF, Maki-Nunes C, et al. The impact of obstructive sleep apnea on metabolic and inflammatory markers in consecutive patients with metabolic syndrome. PLoS One. 2010;5:e12065. https://doi.org/10.1371/journal.pone.0012065 PMid:20711453 PMCid:PMC2920316 DOI: https://doi.org/10.1371/journal.pone.0012065

Tan KC, Chow WS, Lam JC, Lam B, Wong WK, Tam S, Ip MS. HDL dysfunction in obstructive sleep apnea. Atherosclerosis. 2006;184:377-82. https://doi.org/10.1016/j.atherosclerosis.2005.04.024 PMid:15975582 DOI: https://doi.org/10.1016/j.atherosclerosis.2005.04.024

Tokuda F, Sando Y, Matsui H, Koike H, Yokoyama T. Serum levels of adipocytokines, adiponectin and leptin, in patients with obstructive sleep apnea syndrome. Intern Med. 2008;47:1843-9. https://doi.org/10.2169/internalmedicine.47.1035 PMid:18981626 DOI: https://doi.org/10.2169/internalmedicine.47.1035

Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, et al. American Academy of Sleep Medicine. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2012 Oct 15;8(5):597-619. PMid:23066376 PMCid:PMC3459210 DOI: https://doi.org/10.5664/jcsm.2172

Levy P, Bonsignore MR, Eckel J. Sleep, sleep-disordered breathing and metabolic consequences. Eur Respir J. 2009; 34: 243–260. https://doi.org/10.1183/09031936.00166808 PMid:19567607 DOI: https://doi.org/10.1183/09031936.00166808

McNicholas WT, Bonsigore MR. Sleep apnoea as an independent risk factor for cardiovascular disease: current evidence, basic mechanisms and research priorities. Eur Respir J. 2007; 29: 156–178. https://doi.org/10.1183/09031936.00027406 PMid:17197482 DOI: https://doi.org/10.1183/09031936.00027406

Ip MS, Lam KS, Ho C, Tsang KW, Lam W. Serum leptin and vascular risk factors in obstructive sleep apnea. Chest. 2000; 118: 580–586. https://doi.org/10.1378/chest.118.3.580 DOI: https://doi.org/10.1378/chest.118.3.580

Robinson GV, Pepperrell JC, Segal HC, Davies RJ, Stradling JR. Circulating cardiovascular risk factors in obstructive sleep data from randomized controlled trials. Thorax. 2004; 59: 777–782. https://doi.org/10.1136/thx.2003.018739 PMid:15333855 PMCid:PMC1747125 DOI: https://doi.org/10.1136/thx.2003.018739

Newman AB, Nieto FJ. Relation of sleep-disordered breathing to cardiovascular disease risk factors—the Sleep Heart Health Study. Am J Epidemiol. 2001; 154: 50–59. https://doi.org/10.1093/aje/154.1.50 DOI: https://doi.org/10.1093/aje/154.1.50

Lam JC, Lam B, Lam CL et al. Obstructive sleep apnea and the metabolic syndrome in community-based Chinese adults in Hong Kong. Respir Med. 2006; 100: 980-987. https://doi.org/10.1016/j.rmed.2005.10.003 PMid:16337115 DOI: https://doi.org/10.1016/j.rmed.2005.10.003

St-Onge MP, Janssen I, Heymsfield SB: Metabolic syndrome in normal-weight Americans: new definition of the metabolically obese, normal-weight individual. Diabetes Care. 2004, 27: 2222-2228. https://doi.org/10.2337/diacare.27.9.2222 PMid:15333488 DOI: https://doi.org/10.2337/diacare.27.9.2222

Conus F, Rabasa-Lhoret R, Peronnet F. Characteristics of metabolically obese normal-weight (MONW) subjects. Applied physiology, nutrition, and metabolism. 2007;32(1):4-12. https://doi.org/10.1139/h06-092 DOI: https://doi.org/10.1139/h06-092

Şahin M, Berçik İnal B, Öğreden S, Yiğit O, Aralı H, Güvenen G. Metabolic profile and insulin resistance in patients with obstructive sleep apnea syndrome. Turk J Med Sci. 2011; 41: 443–54. DOI: https://doi.org/10.3906/sag-1006-895

Sharma SK, Kumpawat S, Goel A, Banga A, Ramakrishnan L, Chaturvedi P. Obesity and not obstructive sleep apnea is responsible for metabolic abnormalities in a cohort with sleep-disordered breathing. Sleep Med. 2007; 8: 12–17. https://doi.org/10.1016/j.sleep.2006.06.014 PMid:17157064 DOI: https://doi.org/10.1016/j.sleep.2006.06.014

Schäfer H, Pauleit D, Sudhop T, Gouni-Berthold I, Ewig S, Berthold HK. Body fat distribution, serum leptin, and cardiovascular risk factors In men with obstructive sleep apnea. Chest. 2002; 122: 829–839. https://doi.org/10.1378/chest.122.3.829 PMid:12226021 DOI: https://doi.org/10.1378/chest.122.3.829

Wildman RP, Muntner P, Reynolds K, et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Arch Intern Med. 2008;168:1617–1624. https://doi.org/10.1001/archinte.168.15.1617 PMid:18695075 DOI: https://doi.org/10.1001/archinte.168.15.1617

Published

2017-01-18

How to Cite

1.
Karkinski D, Georgievski O, Dzekova-Vidimliski P, Milenkovic T, Dokic D. Obstructive sleep apnea and lipid abnormalities. Open Access Maced J Med Sci [Internet]. 2017 Jan. 18 [cited 2024 Apr. 20];5(1):19-22. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2017.011

Issue

Section

B - Clinical Sciences

Most read articles by the same author(s)