Atherogenic Index of Plasma in Obstructive Sleep Apnoea

Andras Bikov,Alina Gabriela Negru,Stefan Marian Frent,Laszlo Kunos,Stefan Mihaicuta,Martina Meszaros

doi:10.3390/jcm10030417

Abstract

Background: Dyslipidaemia is well recognised in obstructive sleep apnoea (OSA) and could contribute to the development of cardiovascular disease (CVD). Atherogenic index of plasma (AIP) predicts cardiovascular morbidity and mortality better than the individual lipid levels. The aim of this study was to investigate the AIP in patients with OSA in relation with disease severity. Methods: Four hundred sixty-one patients with OSA and 99 controls participated in this study. AIP was assessed in the morning following a diagnostic sleep study. The association between lipid values and OSA were adjusted for age, gender, and body mass index. Results: Patients with OSA had higher AIP and triglyceride, and lower high-density lipoprotein cholesterol (HDL-C) levels (all p < 0.05). AIP significantly correlated with the Epworth Sleepiness Scale score (ρ = 0.19), the apnoea-hypopnoea index (ρ = 0.40) and oxygen desaturation index (ρ = 0.43, all p < 0.05). However, there was no relationship between the AIP and markers of sleep quality such as total sleep time, sleep period time, sleep efficiency, arousal index or percentage of REM sleep (all p > 0.05). AIP was not a better predictor for self-reported cardiovascular disease or diabetes than HDL-C. Conclusions: AIP is elevated in OSA and is related to disease severity. However, it does not seem to have an additional clinical value compared to HDL-C.

Highlights

Introduction published maps and institutional affilObstructive sleep apnoea (OSA) is a common disease which is characterised by a repetitive collapse of the upper airways during sleep resulting in chronic intermittent hypoxaemia and frequent microarousals
We recorded total sleep time (TST), sleep period time (SPT), percentage of rapid eye movement sleep (REM%) and minimal oxygen saturation (MinSatO2) and calculated Sleep efficiency (Sleep%, TST/SPT), AHI, oxygen desaturation index (ODI), arousal index (AI) and the percentage of total sleep time spent with saturation below 90% (TST90%)
AHI—apnoea hypopnoea index; Atherogenic index of plasma (AIP)—atherogenic index of plasma; BMI—body mass index; COPD—chronic obstructive pulmonary disease; ESS—Epworth Sleepiness Scale; HDL-C—high-density lipoprotein cholesterol; Low-density lipoprotein (LDL)-C—low-density lipoprotein cholesterol; MinSatO2—minimal oxygen saturation; ODI—oxygen desaturation index; REM%—the percentage of REM sleep of the total sleep time; SPT—Sleep period time; Sleep%—sleep efficiency; TC—total cholesterol; TGs—triglycerides; TST—total sleep time; TST90%—the percentage of total sleep time spent with oxygen saturation below 90%. * Estimated in 488 subjects

Summary

Introduction

Obstructive sleep apnoea (OSA) is a common disease which is characterised by a repetitive collapse of the upper airways during sleep resulting in chronic intermittent hypoxaemia and frequent microarousals. OSA is a well-known risk factor for cardiovascular and cerebrovascular disease [1]; the treatment of OSA with continuous positive airway pressure (CPAP) has only a marginal effect on cardiovascular mortality [2]. Dyslipidaemia is an essential component in the pathophysiology of atherosclerosis [3]. High triglyceride (TG) levels are independently related to cardiovascular risk [5]. Dyslipidaemia is well recognised in obstructive sleep apnoea (OSA) and could contribute to the development of cardiovascular disease (CVD). Atherogenic index of plasma (AIP) predicts cardiovascular morbidity and mortality better than the individual lipid levels. The aim of this study was to investigate the AIP in patients with OSA in relation with disease severity

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Discussion

Conclusion