The Association of Obstructive Sleep Apnea and Nocturnal Hypoxemia with Lipid Profiles in a Population-Based Study of Community-Dwelling Australian Men

Objective: To determine the association of obstructive sleep apnea and nocturnal hypoxemia with serum lipid profiles in unselected community-dwelling men. Methods: Cross-sectional data from participants of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study (n=753) who underwent full in-home polysomnography (Embletta X100) was used. Triglycerides, high- (HDL), low-density lipoprotein (LDL), and total cholesterol were assessed on a fasting morning blood sample. Multivariable linear regression analyses assessed associations between lipids and continuous measures of nocturnal hypoxemia (oxygen desaturation index (3%) (ODI), apnea-hypopnea index (AHI), and rapid eye movement sleep apnea-hypopnea index (REM-AHI)), adjusted for chronic conditions, risk behavior and sociodemographic factors. Sensitivity analyses examined the effect of lipid lowering therapies on reported estimates. Effect modification was examined through stratification by waist circumference groups. Results: In 753 participants with mean (SD) age of 60.8 (10.9) years and waist circumference: 99.3 (11.6) cm, the prevalence of OSA (AH1>10) was 52.6%. Overall, no significant associations between OSA metrics and lipid measures were found. Similarly, sensitivity analysis excluding lipid lowering therapies showed no significant associations. In analysis stratified by waist circumference (<95cm, 95-100cm, >100cm), ODI (3%, unstandardized B: 0.027, 95% CI: 0.015-0.040), AHI (0.023, 0.012-0.033) and AHIREM (0.012, 0.001-0.022) were positively associated with serum triglycerides in participants with a normal waist circumference (<95cm). Conclusion: Obstructive sleep apnea metrics were positively associated with serum triglyceride levels in men with a normal waist circumference. Healthy weight individuals with OSA require clinical attention to improve cardiometabolic risk profiles.