Associations between lipid metabolism-related inflammation and obstructive sleep apnea risk and severity

Lipid metabolism-related inflammatory indices (LMIIs) primarily refer to markers associated with blood cells and high-density lipoprotein cholesterol (HDL-C), such as platelet to HDL-C (PHR), neutrophil to HDL-C (NHR), lymphocyte to HDL-C (LHR), and monocyte to HDL-C (MHR). This study aimed to explore the association between LMIIs and risk and severity of OSA.

The study retrospectively collected participants' basic information and laboratory biochemical test results, and calculated LMIIs. Cluster heatmap was used to assess the association between LMIIs and OSA parameters. Logistic regression and restricted cubic spline analysis were used to assess the association between MHR and risk and severity of OSA. Receiver operating characteristic curves of MHR were plotted to evaluate the predictive models' performance using area under the curve.

The study included a total of 5306 participants, including 639 with OSA. Participants in the OSA group had higher levels of TG, neutrophil, monocyte, PHR, NHR, and MHR, and lower levels of HDL-C, lymphocyte, and LHR (all P < 0.01). Logistic regression showed that gender, BMI, alcohol consumption, hypertension, and coronary heart disease are positively associated with OSA risk, while age and HDL-C are negatively associated with it (all P < 0.05). Results from different models consistently indicate that high MHR (OR = 1.398-3.474, all P < 0.05) is most closely associated with OSA risk compared with PHR, NHR, and LHR. Among these LMIIs, MHR demonstrated the strongest performance, showing positive correlations with AHI, AI, HI, and ODI (r = 0.29-0.44, all P < 0.001) and negative correlations with LSpO₂ (r = -0.29, P < 0.001). But the association between MHR and OSA severity requires careful interpretation. Besides, MHR also demonstrated moderate performance (AUC = 0.732, 95%CI: 0.713-0.752) in predicting the risk of developing OSA after adjusting for the aforementioned variables CONCLUSIONS: The study revealed the relationship between LMIIs and risk and severity of OSA, particularly highlighting the importance of monocyte and MHR in the clinical stratification and management of OSA.