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Sleep and Breathing
Published in: Sleep and Breathing 4/2021

01-12-2021 | Insomnia | Sleep Breathing Physiology and Disorders • Original Article

Obstructive sleep apnea is associated with lower adiponectin and higher cholesterol levels independently of traditional factors and other sleep disorders in middle-aged adults: the ELSA-Brasil cohort

Authors: Wagner A. Silva, Bianca Almeida-Pititto, Ronaldo B. Santos, Aline N. Aielo, Soraya Giatti, Barbara K. Parise, Silvana P. Souza, Sandra F. Vivolo, Paulo A. Lotufo, Isabela M. Bensenor, Luciano F. Drager

Published in: Sleep and Breathing | Issue 4/2021

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Abstract

Purpose

Obstructive sleep apnea (OSA) may contribute to metabolic and inflammatory deregulation but previous studies failed to consider sleep duration, sleep fragmentation, insomnia, and daytime sleepiness as potential confounders.

Methods

Consecutive non-diabetic middle-aged participants from the ELSA-Brasil cohort were invited to perform a clinical evaluation, home sleep study for 1 night, and wrist actigraphy for 7 days. OSA was defined by an apnea-hypopnea index ≥ 15 events/h. Participants were stratified according to the presence of OSA measuring the following markers: fasting glucose, glucose tolerance test, homeostatic model assessment of insulin resistance (HOMA-IR) index, fasting insulin, insulin after 2 h of glucose load, glycated hemoglobin, total cholesterol and their fractions, triglycerides, C-reactive protein, TNF-alpha, interleukin-6, interleukin-10, leptin, adiponectin, E-selectin, ADMA, MCP-1, TGF, apolipoprotein B, fibrinogen, and lipoprotein(a). Differences between groups were identified by chi-square test and ANOVA.

Results

We studied 708 participants (mean age: 46 ± 5 years, men: 44%, BMI 26.1 ± 4.1 kg/m2). Compared to no OSA, participants with OSA presented higher levels while fasting and after 2 h glucose load of insulin, HOMA-IR, cholesterol, triglycerides, and C-reactive protein (all p < 0.001). After linear regression analysis adjusting for traditional risk factors plus sleep duration, fragmentation, insomnia, and daytime sleepiness, OSA was negatively associated with adiponectin (β = − 0.271 CI 95% − 0.456 − 0.085) and positively associated with cholesterol (β = 9.707 CI 95% 2.737 16.678). Sex-stratification revealed that these associations were significant for men but not women.

Conclusions

In non-diabetic middle-age adults, men with OSA presented with lower adiponectin and higher cholesterol levels independently of sleep duration, sleep fragmentation, insomnia, and daytime sleepiness.
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Metadata
Title
Obstructive sleep apnea is associated with lower adiponectin and higher cholesterol levels independently of traditional factors and other sleep disorders in middle-aged adults: the ELSA-Brasil cohort
Authors
Wagner A. Silva
Bianca Almeida-Pititto
Ronaldo B. Santos
Aline N. Aielo
Soraya Giatti
Barbara K. Parise
Silvana P. Souza
Sandra F. Vivolo
Paulo A. Lotufo
Isabela M. Bensenor
Luciano F. Drager
Publication date
01-12-2021
Publisher
Springer International Publishing
Published in
Sleep and Breathing / Issue 4/2021
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-021-02290-7

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