The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and obstructive sleep apnea : a cross-sectional study

Author:

Chen Kehan1,Zou Zhijiang1,Lou Yuhang1,Mei Ruoyu1,Liu Zhongzheng1,Xu Bing1,He Wei1,Song Jukun2

Affiliation:

1. The Affiliated Stomatological Hospital of Zunyi Medical University

2. Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Guizhou Medical University, Guiyang, China

Abstract

Abstract

Background Obstructive Sleep Apnea (OSA) is a common sleep disorder characterized by repeated instances of either partial or total blockage of the upper airway while sleeping. This leads to disrupted sleep and several related health issues. The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is a novel indicator that has the potential to provide more accurate assessment of the risk for cardiovascular and cerebrovascular illnesses. This study sought to explore the relationship between NHHR and OSA. Methods This research included cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2008, as well as between 2015 and 2018. The study included a total of 19,234 individuals. The NHHR was determined by dividing the non-high-density lipoprotein cholesterol by the high-density lipoprotein cholesterol. The participants were divided into quartiles according to their NHHR levels. OSA was characterized by symptoms described by the individuals themselves, such as extreme tiredness throughout the day, gasping or snorting during asleep, and frequent snoring. The link between NHHR and OSA was evaluated using multivariate logistic regression and segmented linear regression models. Results In this research, 19,234 individuals with a mean age of 41.88 ± 20.58 years were included. Among them, 50.46% were diagnosed with OSA. The mean and standard deviation for NHHR were measured as 3.08 ± 1.51.An elevated NHHR was shown to be substantially correlated with a higher risk of OSA, with an odds ratio (OR) of 1.113 and a 95% confidence interval (CI) ranging from 1.807 to 1.140 (p < 0.001). The observed correlation remained significant even after controlling for possible confounding variables such as age, gender, race, and other characteristics associated to health.An inverted U-shaped association was identified, which was nonlinear. The turning point of this relationship occurred at an NHHR value of 5.198.When the NHHR was below a certain level, each additional unit rise in NHHR resulted in a 17% increase in the risk of OSA. However, when the NHHR was beyond this level, the risk of OSA remained constant. Conclusions The presence of NHHR is a strong indicator of the probability of developing OSA. This highlights the crucial need to closely monitor and control lipid profiles in patients who have or are at risk of developing OSA. These findings provide fresh perspectives on the connection between lipid metabolism and OSA, indicating that NHHR might serve as a helpful indicator in clinical evaluations.

Publisher

Springer Science and Business Media LLC

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