Gender Differences In The Relationship Between OSAHS And Dyslipidemia

Objectives It’s reported that obstructive sleep apnea-hypopnea syndrome（OSAHS）is associated with dyslipidemia.OSAHS is obviously more prevalent in male than in female,and gender differences may exist in the relationship between OSAHS and dyslipidemia.This study aimed to figure out if gender differences existed in the relationship through a large-scale cross-sectional study.Methods We enrolled 2983 subjects from Sleep center of Shanghai Jiao Tong University Affiliated Sixth People’s hospital,including 570 females and2413 males.Data including clinical information,polysomnography parameters,anthropometric measurements,serum lipids,fasting glucose and insulin were collected.In the first part,subjects were divided into female group and male group.Serum lipid levels were compared between male and female after adjusting for confounding factors.Subgroup analyses were performed in patients with OSAHS and subjects without diagnosis of OSAHS.Meanwhile,relationship between sex and dyslipidemia were determined by logistic regression.In the second part,female were divided into three groups,including no to mild OSAHS,moderate OSAHS and severe OSAHS group.After adjusting for confounding factors,serum lipid levels were compared among the three groups,and P for trend was tested.Logistic regression was used to determine the independent risk factors influencing dyslipidemia.Relationship between OSAHS and dyslipidemia in female were explored.In the third part,according to the above-mentioned grouping principles and statistical methods in the second part,relationship between OSAHS and dyslipidemia in male was explored.Results After adjusting for age,BMI,waist-to-hip ratio（WHR）,glycometabolism index,smoking,drinking and OSAHS-related indicators（AHI,ODI,MAI and LSpO₂）,significant differences in total cholesterol（TC）,triglycerides（TG）and high-density lipoprotein cholesterol（HDL-C）were seen between male and female in patients with OSAHS（4.87±0.94 vs4.95±0.94,2.04±1.25 vs 1.64±1.03,1.05±0.22 vs 1.23±0.26,respectively,all P<0.05）,and HDL-C differed between male and female in subjects without diagnosis of OSAHS（1.11±0.27 vs 1.26±0.28,P<0.01）.Meanwhile,female were at lower risks of dyslipidemia than male.In female subjects,after adjusting for age,BMI,WHR and glycometabolism index,no major differences existed in TC,TG,HDL-C,low-density lipoprotein cholesterol（LDL-C）,apolipoprotein A-I（apoA-I）and apoE levels among no to mild OSAHS group,moderate OSAHS group,and severe OSAHS group（all P>0.05）,and the serum lipid levels did not change significantly with elevating OSAHS severity（all P-for trend>0.05）.Age,BMI,WHR and glycometabolism index were major risk factors for dyslipidemia.No significant independent associations between OSAHS-related indicators（including AHI,ODI,MAI and LSpO₂）and dyslipidemia were seen（except hyper apoB）.In male subjects,after adjusting for multivariate,TC,TG,HDL-C,LDL-C,apoA-I,apoB and apoE levels significantly differed among three groups（all P<0.05）,and serum lipid levels increased or decreased with OSAHS severity（except HDL-C）（all P-for trend<0.05）.OSAHS-related indicators were significantly independently associated with dyslipidemia.Conclusion In patients with OSAHS,serum lipids significantly differed between male and female,and females were at lower risks of dyslipidemia.In female,age,obesity/central obesity and glycometabolism index were major risk factors of dyslipidemia,and OSAHS itself held limited impact on serum lipids.In male,linear associations between OSAHS severity and serum lipid levels were seen,and OSAHS was significantly associated with dyslipidemia.Thus,gender differences existed in the relationship between OSAHS and dyslipidemia.