Association between high risk of obstructive sleep apnea and inflammatory markers in a population sample of young and middle-aged adults in the Miami Heart Study.

STUDY

OBJECTIVES

There are limited data depicting the association between high risk of obstructive sleep apnea (OSA) and the levels of inflammatory markers in a population-based sample free from cardiovascular disease (CVD). In a large US cohort enriched with a Hispanic population and free of CVD, we aimed to assess the association between high risk of OSA and inflammatory markers.

METHODS

We analyzed data for 2,359 clinical CVD-free participants from the Miami Heart Study, aged 40-65 years (May 2015-September 2018). High risk of OSA included those with a high risk using the Berlin Questionnaire. Poisson regression analyses were used to examine the associations between high risk of OSA (reference: low risk of OSA) and high-sensitivity C-reactive protein (hs-CRP), interleukin 6, and tumor necrosis factor alpha levels (continuous) in univariate and multivariate models (adjusting for age, sex, race/ethnicity, and body mass index, diabetes, hypertension, high cholesterol, and smoking).

RESULTS

A total of 552 (28%) participants were categorized as having a high risk of OSA. Patients with a high risk of OSA had higher median values of hs-CRP (2.3 vs 1.0), interleukin 6 (1.9 vs 1.4), and tumor necrosis factor alpha (1.2 vs 1.1) compared with those with a low risk of OSA (all P < .001). When adjusting for age, sex, and race/ethnicity, the mean difference between patients with high and low risk of OSA in hs-CRP was 2.04 (95% confidence interval, 1.85, 2.23) and 0.73 (95% confidence interval, 0.57, 0.89) in interleukin 6. These differences were attenuated when further adjusting for CVD risk factors but remained statistically significant for hs-CRP (0.38; 95% confidence interval, 0.21, 0.55).

CONCLUSIONS

After accounting for CVD risk factors, individuals at high risk of OSA had significantly higher levels of hs-CRP, suggesting that OSA screening identified subclinical inflammation in this population sample of individuals free of CVD.

CITATION: Khosla AA, Nasir K, Saxena A, et al. Association between high risk of obstructive sleep apnea and inflammatory markers in a population sample of young and middle-aged adults in the Miami Heart Study. J Clin Sleep Med. 2024;20(12):1895-1903.