Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China.
Medicine (Baltimore). 2024 Oct 4;103(40):e39965. doi: 10.1097/MD.0000000000039965.
The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol, abbreviated as NHHR, represents a brand-new lipid biomarker for assessing cardiovascular disease risk. Research has suggested a link between lipid metabolism and obstructive sleep apnea (OSA). To delve deeper, this study was carried out using data derived from the NHANES to ascertain whether NHHR and OSA are associated. In this research, a cross-sectional analysis was executed based on data derived from NHANES across the years 2005 to 2008 and 2015 to 2020. After adjusting for confounders such as demographic characteristics, lifestyle, and health status, the link between NHHR and the likelihood of developing OSA was examined via weighted binary logistic regression as well as restricted cubic spline (RCS) models. In addition, subgroup analysis was completed to check if the obtained results were reliable. The study included 16,265 adult participants. Following comprehensive adjustment for confounders, results obtained suggested that, for each additional unit increment of NHHR, there is a 9% increased chance of developing OSA. Compared to the lowest quartile, the highest quartile of NHHR notably increased the risk of developing OSA in the overall population (OR: 1.65; 95% CI: 1.38-1.98; P < .001). The RCS curve indicated a linear positive correlation between NHHR and OSA, which remained significant in subsequent subgroup analyses (all P for interaction > .05). This suggested that the correlation between NHHR and OSA was stable across populations with different characteristics. Confounders such as demographics, lifestyle, and health status did not significantly affect this positive correlation. Findings from this study uncovered a strong connection between NHHR and an increased possibility of developing OSA in American adults. Further exploration of NHHR could offer insights into OSA prevention and treatment. However, owing to the constraints inherent in cross-sectional studies, more studies are required to establish a concrete link between NHHR and OSA.
非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值，简称 NHHR，是评估心血管疾病风险的全新脂质生物标志物。研究表明，脂代谢与阻塞性睡眠呼吸暂停（OSA）之间存在关联。为了深入研究这一问题，本研究利用 NHANES 数据来确定 NHHR 和 OSA 是否存在关联。
本研究采用了横断面分析方法，基于 2005 年至 2008 年和 2015 年至 2020 年 NHANES 数据进行分析。在调整了人口统计学特征、生活方式和健康状况等混杂因素后，采用加权二项逻辑回归和限制性三次样条（RCS）模型来检验 NHHR 与 OSA 发生概率之间的关系。此外，还进行了亚组分析以验证结果的可靠性。
该研究共纳入了 16265 名成年参与者。经过全面调整混杂因素后，结果表明，NHHR 每增加一个单位，患 OSA 的概率就会增加 9%。与最低四分位相比，NHHR 的最高四分位明显增加了总体人群患 OSA 的风险（OR：1.65；95%CI：1.38-1.98；P<0.001）。RCS 曲线表明，NHHR 与 OSA 之间呈线性正相关，且在后续的亚组分析中仍具有统计学意义（交互 P 值均>0.05）。这表明，NHHR 与 OSA 之间的相关性在具有不同特征的人群中是稳定的。混杂因素如人口统计学特征、生活方式和健康状况并未显著影响这种正相关关系。
本研究揭示了美国成年人中 NHHR 与 OSA 发生概率增加之间存在紧密联系。进一步探索 NHHR 可能为 OSA 的预防和治疗提供新的思路。然而，由于横断面研究的固有局限性，还需要更多的研究来建立 NHHR 与 OSA 之间的确切联系。
