Hyperlipidemia Prevalence and Cholesterol Control in Obstructive Sleep Apnea: Data from the European Sleep Apnea Database (ESADA)

BACKGROUND AND OBJECTIVE: Obstructive sleep apnea (OSA) and hyperlipidemia are independent risk factors for cardiovascular disease. This study investigates the association between OSA and prevalence of hyperlipidemia in patients of the European Sleep Apnea Database (ESADA) cohort. METHODS: The cross-sectional analysis included 11,892 patients (age 51.9±12.5 years, 70% male, body mass index (BMI) 31.3±6.6 kg/m2 , mean Oxygen Desaturation Index (ODI) 23.7±25.5 events/h) investigated for OSA. The independent odds ratio (OR) for hyperlipidemia in relation to measures of OSA (ODI, Apnea Hypopnea Index, mean and lowest oxygen saturation) was determined by means of General Linear Model analysis with adjustment for important confounders like age, BMI, comorbidities, and study site. RESULTS: Hyperlipidemia prevalence increased from 15.1% in subjects without OSA to 26.1% in those with severe OSA, p<0.001. Corresponding numbers in diabetic patients were 8.5% and 41.5%, p<0.001. Compared with ODI quartile I, patients in ODI quartiles II-IV had an adjusted OR (95% CI) of 1.33 (1.15-1.55), 1.37 (1.17-1.61), and 1.33 (1.12-1.58) (p <0.001), respectively, for hyperlipidemia. Obesity was defined as a significant risk factor for hyperlipidemia. Subgroups of OSA patients with cardio-metabolic comorbidities demonstrated higher prevalence of HL. In addition, differences in hyperlipidemia prevalence was reported in European geographical regions with the highest prevalence in central Europe. CONCLUSION: OSA, in particular intermittent hypoxia, was independently associated with the prevalence of hyperlipidemia diagnosis.