Association between obstructive sleep apnea risk and atherosclerosis: A nationwide cross-sectional study in the Korean population

Abstract

Objectives Obstructive sleep apnea (OSA) increases the risk of all-cause and cardiovascular mortality. This study aimed to investigate the association between OSA and atherogenic risk in the Koreans. Methods Data from 8,158 participants (mean age, 57.9 ± 11.7; male/female, 1:1.4) obtained from the Korea National Health and Nutrition Examination Survey between 2019 and 2021. OSA risk was screened using the STOP-BANG score, and atherogenic risk was measured using the atherogenic index of plasma (AIP). Logistic regression was used to evaluate the association between the STOP-BANG scores and high AIP and subgroups according to the presence of diabetes. Results The proportions of individuals with atherogenic risk (AIP > 0.24) were 13.7%, 27.6%, and 34.7% in the low-, intermediate-, and high-OSA risk groups (p < 0.001). After adjustment, individuals with intermediate and high OSA risk had 1.35 (95% confidence interval [CI], 1.16–1.58; p < 0.001) and 1.32 (95% CI, 1.08–1.61; p = 0.006) times higher odds of having atherogenic risk than those with low OSA risk. Among patients without diabetes, high OSA risk was not an independent factor affecting atherogenic risk (hazard ratio [HR], 1.17; 95% CI, 0.93–1.47). However, among patients with diabetes, compared with those with low OSA risk, those with intermediate (HR, 1.51; 95% CI, 1.05–2.19) and high OSA risk (HR, 1.58; 95% CI, 1.02–2.46) had significantly increased atherogenic risk. Conclusion OSA is linked to increased atherogenic risk in the Koreans, especially in individuals with diabetes, thus highlighting the importance of routine OSA screening to manage and reduce cardiovascular risks.