Relationship Between Blood Lipid Levels And Disease Severity In Patients With Obstructive Sleep Apnea Syndrome(OSAS)

Objectives:The causal relationship between OSAS and dyslipidemia has not been conclusively established,but there is a complex interplay involved in the pathophysiology and mechanism of OSA-mediated dyslipidemia,which is a potent risk factor for adverse cardiovascular diseases.Therefore,the assessment of lipid parameters can play a significant role in predicting the higher risk of cardiovascular diseases in patients with obstructive sleep apnea.This study aims to assess the relationship between unconventional lipid levels and OSAS severity.Methods:The retrospective cohort study included 267 patients newly diagnosed with OSAS through polysomnography(PSG).The association of traditional lipid parameters,including Total Cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C),with the severity of OSAS was assessed.In addition,the association of non-traditional lipid parameters,including TC/HDL-C ratio,TG/HDL-C ratio,LDL-C/HDL-C ratio,non-HDL-C,atherogenic index(AI),and lipoprotein combine index(LCI)with the severity of OSAS was calculated.We have also performed a sub-group analysis based on the obesity,age,and gender of the participants.Finally,we performed univariate and multivariate regression analysis to assess the effect of several discussed factors on the severity of the OSAS.A P-value<0.05 was considered to indicate statistical significance.Results:In our research,there were a significant association of TG,HDL-C,TC/HDL-C ratio,TG/HDL-C ratio,LDL-C/HDL-C ratio,AI,and LCI with the severity of OSAS(P<0.05).On sub-group analysis,the association of these lipid parameters were more pronounced in the age group≥65 years and the non-obese group with BMI<28 kg/m2.Moreover,the male group had significant differences in the TC/HDL-C ratio and AI.While in the female group,there were significant differences in TG/HDL-C ratio.On the regression analysis results,gender,obesity,hypertension,Congestive heart failure,TG,HDL-C,TC/HDL-C ratio,TG/HDL-C ratio,LDL-C/HDL-C ratio,and AI showed statistically significant effects on severe OSAS.Conclusion:Two traditional lipid parameters(TG and HDL-C),and five nontraditional lipid parameters(TC/HDL-C ratio,TG/HDL-C ratio,LDL-C/HDL-C ratio,AI,and LCI)were found to be strongly associated with the severity of OSAS(P<0.05).These lipid parameters were more potent indicators of OSAS severity in patients≥65 years of age,and those with BMI<28 kg/m2.Moreover,TC/HDL-C ratio,and AI were more pronounced in the male sub-group,while TG/HDL-C ratio were more pronounced in the female sub-group.These associations can help to predict cardiovascular disease risk in patients with OSAS.