Abstract
Purpose: Obstructive sleep apnoea (OSA) represents a risk for dyslipidaemia. Obstructive respiratory events during rapid eye movement (REM) sleep are more strongly related to the development of hypertension and diabetes than in non-REM. However, the relationship between sleep phases and serum lipid profile is unclear. We aimed to analyse the relationship between obstructive respiratory events in REM and non-REM sleep as well as serum lipid profile. Methods: Polysomnography was performed in 94 adult subjects who did not take any lipid-modifying medications. Fasting venous blood sample was taken the following morning for total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, lipoprotein(a), apoprotein A1 (ApoA1) and for apoprotein B (ApoB) measurements. Lipid profiles were correlated with apnoea–hypopnoea index (AHI) during REM (AHI REM) and non-REM (AHI NREM) stages in all subjects. In addition, lipid profiles were compared between REM-dependent OSA patients (AHI REM ≥ 5/h, but AHI NREM < 5/h) and control subjects (both AHI REM and AHI NREM < 5/h). Results: AHI REM correlated only with triglyceride concentrations (p = 0.04, Spearman’s rho, ρ = 0.21). In contrast, there was a significant association between AHI NREM and triglyceride (p = 0.02, ρ = 0.23), ApoB (p = 0.03, ρ = 0.21), HDL-C (p < 0.01, ρ = − 0.32) as well as ApoA1 levels (p = 0.04, ρ = − 0.21). However, these correlations were not present after adjustment for BMI (all p > 0.05). There was no difference in the lipid profile of REM-dependent OSA subjects and healthy controls (p > 0.05). Conclusions: Altered serum lipid profile is equally associated with a disturbed REM and non-REM sleep in OSA. Obesity must be considered as a strong covariate when interpreting lipid data in sleep apnoea.
Original language | English |
---|---|
Journal | Lung |
Early online date | 2 Feb 2019 |
DOIs | |
Publication status | Published - 2019 |
Keywords
- Apolipoproteins
- Dyslipidaemia
- Lipids
- Obstructive sleep apnoea
- REM sleep
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In: Lung, 2019.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Association Between Serum Lipid Profile and Obstructive Respiratory Events During REM and Non-REM Sleep
AU - Bikov, A.
AU - Lazar, Z.
AU - Horvath, P.
AU - Tarnoki, D.L.
AU - Tarnoki, A.D.
AU - Fesus, L.
AU - Horvath, M.
AU - Meszaros, M.
AU - Losonczy, G.
AU - Kunos, L.
N1 - Export Date: 20 February 2019 CODEN: LUNGD Correspondence Address: Bikov, A.; Department of Pulmonology, Semmelweis University, 1/C Dios arok, Hungary; email: [email protected] References: Gileles-Hillel, A., Kheirandish-Gozal, L., Gozal, D., Biological plausibility linking sleep apnoea and metabolic dysfunction (2016) Nat Rev Endocrinol, 12 (5), pp. 290-298; Guan, J., Yi, H., Zou, J., Meng, L., Tang, X., Zhu, H., Yu, D., Yin, S., Distinct severity stages of obstructive sleep apnoea are correlated with unique dyslipidaemia: large-scale observational study (2016) Thorax, 71 (4), pp. 347-355; Adedayo, A.M., Olafiranye, O., Smith, D., Hill, A., Zizi, F., Brown, C., Jean-Louis, G., Obstructive sleep apnea and dyslipidemia: evidence and underlying mechanism (2014) Sleep Breath Schlaf Atmung, 18 (1), pp. 13-18; Catapano, A.L., Graham, I., De Backer, G., Wiklund, O., Chapman, M.J., Drexel, H., Hoes, A.W., Zamorano, J.L., 2016 ESC/EAS guidelines for the management of dyslipidaemias: the Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) developed with the special contribution of the European Assocciation for Cardiovascular Prevention & Rehabilitation (EACPR) (2016) Atherosclerosis, 253, pp. 281-344; Wu, W.T., Tsai, S.S., Shih, T.S., Lin, M.H., Chou, T.C., Ting, H., Wu, T.N., Liou, S.H., The association between obstructive sleep apnea and metabolic markers and lipid profiles (2015) PLoS ONE, 10 (6); Roche, F., Sforza, E., Pichot, V., Maudoux, D., Garcin, A., Celle, S., Picard-Kossovsky, M., Group, P.S., Obstructive sleep apnoea/hypopnea influences high-density lipoprotein cholesterol in the elderly (2009) Sleep Med, 10 (8), pp. 882-886; Gunduz, C., Basoglu, O.K., Hedner, J., Zou, D., Bonsignore, M.R., Hein, H., Staats, R., Grote, L., Obstructive sleep apnoea independently predicts lipid levels: data from the European Sleep Apnea Database (2018) Respirology, 23 (12), pp. 1180-1189; Pasarica, M., Sereda, O.R., Redman, L.M., Albarado, D.C., Hymel, D.T., Roan, L.E., Rood, J.C., Smith, S.R., Reduced adipose tissue oxygenation in human obesity: evidence for rarefaction, macrophage chemotaxis, and inflammation without an angiogenic response (2009) Diabetes, 58 (3), pp. 718-725; Spiegel, K., Tasali, E., Penev, P., Van Cauter, E., Brief communication: sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite (2004) Ann Intern Med, 141 (11), pp. 846-850; Leren, P., Eide, I., Foss, O.P., Helgeland, A., Hjermann, I., Holme, I., Kjeldsen, S.E., Lund-Larsen, P.G., Antihypertensive drugs and blood lipids: the Oslo study (1982) Br J Clin Pharmacol, 13 (S2), pp. 441S-444S; Spiegel, K., Leproult, R., Van Cauter, E., Impact of sleep debt on metabolic and endocrine function (1999) Lancet, 354 (9188), pp. 1435-1439; Lanfranco, F., Motta, G., Minetto, M.A., Ghigo, E., Maccario, M., Growth hormone/insulin-like growth factor-I axis in obstructive sleep apnea syndrome: an update (2010) J Endocrinol Investig, 33 (3), pp. 192-196; Aurora, R.N., Crainiceanu, C., Gottlieb, D.J., Kim, J.S., Punjabi, N.M., Obstructive sleep apnea during REM sleep and cardiovascular disease (2018) Am J Respir Crit Care Med, 197 (5), pp. 653-660; Appleton, S.L., Vakulin, A., Martin, S.A., Lang, C.J., Wittert, G.A., Taylor, A.W., McEvoy, R.D., Adams, R.J., Hypertension is associated with undiagnosed OSA during rapid eye movement sleep (2016) Chest, 150 (3), pp. 495-505; Mokhlesi, B., Finn, L.A., Hagen, E.W., Young, T., Hla, K.M., Van Cauter, E., Peppard, P.E., Obstructive sleep apnea during REM sleep and hypertension. 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Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine (2012) J Clin Sleep Med, 8 (5), pp. 597-619; Mullington, J.M., Abbott, S.M., Carroll, J.E., Davis, C.J., Dijk, D.J., Dinges, D.F., Gehrman, P.R., Zee, P.C., Developing biomarker arrays predicting sleep and circadian-coupled risks to health (2016) Sleep, 39 (4), pp. 727-736; Drager, L.F., Jun, J., Polotsky, V.Y., Obstructive sleep apnea and dyslipidemia: implications for atherosclerosis (2010) Curr Opin Endocrinol Diabetes Obes, 17 (2), pp. 161-165; Nadeem, R., Singh, M., Nida, M., Waheed, I., Khan, A., Ahmed, S., Naseem, J., Champeau, D., Effect of obstructive sleep apnea hypopnea syndrome on lipid profile: a meta-regression analysis (2014) J Clin Sleep Med, 10 (5), pp. 475-489; Tan, K.C., Chow, W.S., Lam, J.C., Lam, B., Wong, W.K., Tam, S., Ip, M.S., HDL dysfunction in obstructive sleep apnea (2006) Atherosclerosis, 184 (2), pp. 377-382; Tisko, R., Sopkova, Z., Habalova, V., Dorkova, Z., Slaba, E., Javorsky, M., Tkac, I., Tkacova, R., Effects of apolipoprotein E genotype on serum lipids in obstructive sleep apnoea (2014) Eur Respir J, 43 (4), pp. 1097-1105; Horvath, P., Tarnoki, D.L., Tarnoki, A.D., Karlinger, K., Lazar, Z., Losonczy, G., Kunos, L., Bikov, A., Complement system activation in obstructive sleep apnea (2018) J Sleep Res; Landry, S.A., Joosten, S.A., Obstructive sleep apnoea and cholesterol: independence in context (2018) Respirology, 23 (12), pp. 1092-1093; Wolk, R., Shamsuzzaman, A.S., Somers, V.K., Obesity, sleep apnea, and hypertension (2003) Hypertension, 42 (6), pp. 1067-1074; Ford, E.S., Giles, W.H., Dietz, W.H., Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey (2002) JAMA, 287 (3), pp. 356-359; Gaines, J., Vgontzas, A.N., Fernandez-Mendoza, J., Bixler, E.O., Obstructive sleep apnea and the metabolic syndrome: the road to clinically-meaningful phenotyping, improved prognosis, and personalized treatment (2018) Sleep Med Rev, 42, pp. 211-219; Jullian-Desayes, I., Joyeux-Faure, M., Tamisier, R., Launois, S., Borel, A.L., Levy, P., Pepin, J.L., Impact of obstructive sleep apnea treatment by continuous positive airway pressure on cardiometabolic biomarkers: a systematic review from sham CPAP randomized controlled trials (2015) Sleep Med Rev, 21, pp. 23-38; Eden, S., Wiklund, O., Oscarsson, J., Rosen, T., Bengtsson, B.A., Growth hormone treatment of growth hormone-deficient adults results in a marked increase in Lp(a) and HDL cholesterol concentrations (1993) Arterioscler Thromb Vasc Biol, 13 (2), pp. 296-301; Pucci, E., Chiovato, L., Pinchera, A., Thyroid and lipid metabolism (2000) Int J Obes, 24 (S2), pp. S109-S112; Dorkova, Z., Petrasova, D., Molcanyiova, A., Popovnakova, M., Tkacova, R., Effects of continuous positive airway pressure on cardiovascular risk profile in patients with severe obstructive sleep apnea and metabolic syndrome (2008) Chest, 134 (4), pp. 686-692
PY - 2019
Y1 - 2019
N2 - Purpose: Obstructive sleep apnoea (OSA) represents a risk for dyslipidaemia. Obstructive respiratory events during rapid eye movement (REM) sleep are more strongly related to the development of hypertension and diabetes than in non-REM. However, the relationship between sleep phases and serum lipid profile is unclear. We aimed to analyse the relationship between obstructive respiratory events in REM and non-REM sleep as well as serum lipid profile. Methods: Polysomnography was performed in 94 adult subjects who did not take any lipid-modifying medications. Fasting venous blood sample was taken the following morning for total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, lipoprotein(a), apoprotein A1 (ApoA1) and for apoprotein B (ApoB) measurements. Lipid profiles were correlated with apnoea–hypopnoea index (AHI) during REM (AHI REM) and non-REM (AHI NREM) stages in all subjects. In addition, lipid profiles were compared between REM-dependent OSA patients (AHI REM ≥ 5/h, but AHI NREM < 5/h) and control subjects (both AHI REM and AHI NREM < 5/h). Results: AHI REM correlated only with triglyceride concentrations (p = 0.04, Spearman’s rho, ρ = 0.21). In contrast, there was a significant association between AHI NREM and triglyceride (p = 0.02, ρ = 0.23), ApoB (p = 0.03, ρ = 0.21), HDL-C (p < 0.01, ρ = − 0.32) as well as ApoA1 levels (p = 0.04, ρ = − 0.21). However, these correlations were not present after adjustment for BMI (all p > 0.05). There was no difference in the lipid profile of REM-dependent OSA subjects and healthy controls (p > 0.05). Conclusions: Altered serum lipid profile is equally associated with a disturbed REM and non-REM sleep in OSA. Obesity must be considered as a strong covariate when interpreting lipid data in sleep apnoea.
AB - Purpose: Obstructive sleep apnoea (OSA) represents a risk for dyslipidaemia. Obstructive respiratory events during rapid eye movement (REM) sleep are more strongly related to the development of hypertension and diabetes than in non-REM. However, the relationship between sleep phases and serum lipid profile is unclear. We aimed to analyse the relationship between obstructive respiratory events in REM and non-REM sleep as well as serum lipid profile. Methods: Polysomnography was performed in 94 adult subjects who did not take any lipid-modifying medications. Fasting venous blood sample was taken the following morning for total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, lipoprotein(a), apoprotein A1 (ApoA1) and for apoprotein B (ApoB) measurements. Lipid profiles were correlated with apnoea–hypopnoea index (AHI) during REM (AHI REM) and non-REM (AHI NREM) stages in all subjects. In addition, lipid profiles were compared between REM-dependent OSA patients (AHI REM ≥ 5/h, but AHI NREM < 5/h) and control subjects (both AHI REM and AHI NREM < 5/h). Results: AHI REM correlated only with triglyceride concentrations (p = 0.04, Spearman’s rho, ρ = 0.21). In contrast, there was a significant association between AHI NREM and triglyceride (p = 0.02, ρ = 0.23), ApoB (p = 0.03, ρ = 0.21), HDL-C (p < 0.01, ρ = − 0.32) as well as ApoA1 levels (p = 0.04, ρ = − 0.21). However, these correlations were not present after adjustment for BMI (all p > 0.05). There was no difference in the lipid profile of REM-dependent OSA subjects and healthy controls (p > 0.05). Conclusions: Altered serum lipid profile is equally associated with a disturbed REM and non-REM sleep in OSA. Obesity must be considered as a strong covariate when interpreting lipid data in sleep apnoea.
KW - Apolipoproteins
KW - Dyslipidaemia
KW - Lipids
KW - Obstructive sleep apnoea
KW - REM sleep
U2 - 10.1007/s00408-019-00195-7
DO - 10.1007/s00408-019-00195-7
M3 - Article
SN - 0341-2040
JO - Lung
JF - Lung
ER -