Association Between Serum Lipid Profile and Obstructive Respiratory Events During REM and Non-REM Sleep

• Published in: Lung Vol. 197; no. 4; pp. 443 - 450
• Main Authors: Bikov, Andras, Lazar, Zsofia, Horvath, Peter, Tarnoki, David Laszlo, Tarnoki, Adam Domonkos, Fesus, Luca, Horvath, Marton, Meszaros, Martina, Losonczy, Gyorgy, Kunos, Laszlo
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2019; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Apnea; Biomarkers - blood; Body mass; Case-Control Studies; Cholesterol; Correlation analysis; Density; Diabetes mellitus; Diagnosis; Dyslipidemia; Dyslipidemias - blood; Dyslipidemias - diagnosis; Dyslipidemias - etiology; Eye movements; Female; High density lipoprotein; Humans; Hypertension; Lipids; Lipids - blood; Lipoproteins; Lung - physiopathology; Male; Medicine; Medicine & Public Health; Metabolic disorders; Middle Aged; NREM sleep; Pneumology/Respiratory System; REM sleep; Respiration; Risk Factors; Sleep; Sleep apnea; Sleep apnea syndromes; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - physiopathology; Sleep disorders; Sleep, REM; Lipids; Dyslipidaemia; Obstructive sleep apnoea; Apolipoproteins; REM sleep
• ISSN: 0341-2040; 1432-1750; 1432-1750
• DOI: 10.1007/s00408-019-00195-7

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.