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Published on: September 22, 2023
Accelerated Biological Aging and a Nonlinear Risk Threshold for Sleep Apnea: Evidence from NHANES and Mediation by
Jia Guo1, Xiaona Wang1, Ranran Zhao1
1Department of Respiratory Medicine, Beijing Friendship Hospital, Capital Medical University, 100050, Beijing, China.
Background:
The association between accelerated biological aging and sleep apnea remains unclear. This study aimed to investigate the association of phenotypic aging (PhenoAge) with sleep apnea, identify nonlinear patterns and high-risk subgroups, and explore metabolic-oxidative stress (as measured by uric acid-to-HDL ratio, UHR) as a potential mediator.
Methods:
In a cross-sectional analysis of 4,901 adults from NHANES 2005-2008, sleep apnea was self-reported. PhenoAge was calculated from clinical biomarkers. Associations were assessed using multivariable logistic regression and restricted cubic splines; potential mediation by UHR was evaluated.
Results:
Each 1-year increase in PhenoAge was associated with a 3% higher odds of sleep apnea (OR=1.03, 95% CI: 1.01-1.04). A statistically derived nonlinear inflection point at a PhenoAge of 44.09 years was observed. The association was significant only in adults ≥40 years (P-interaction=0.001) and was strongest in males and individuals with obesity. UHR accounted for 6.27% of the association, primarily in adults ≥40 years and individuals with obesity.
Conclusion:
In this cross-sectional study, accelerated biological aging, measured by PhenoAge, was associated with sleep apnea in a dose-dependent and age-delimited manner, with a statistical inflection point at 44.09 years. The modest association via UHR suggests oxidative-metabolic dysregulation as one potential explanatory factor. These exploratory findings provide a framework for hypothesis generation regarding the role of biological aging in sleep apnea.
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