Exploring the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the association between obesity and sleep-disordered breathing

Abstract Purpose Exploring novel mediators affecting the relationship between obesity and sleep-disordered breathing (SDB) is necessary. This study aimed to explore the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the associat...

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Main Authors: Ying Cui, Ziyi Cheng
Format: Article
Language:English
Published: Springer 2025-02-01
Series:Eating and Weight Disorders
Subjects:
Online Access:https://doi.org/10.1007/s40519-025-01717-4
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author Ying Cui
Ziyi Cheng
author_facet Ying Cui
Ziyi Cheng
author_sort Ying Cui
collection DOAJ
description Abstract Purpose Exploring novel mediators affecting the relationship between obesity and sleep-disordered breathing (SDB) is necessary. This study aimed to explore the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the association between body mass index (BMI) and SDB using data from the 2015–2018 National Health and Nutrition Examination Survey (NHANES) cycles. Methods Total 7639 participants were included. SDB was defined based on the self-reported frequency of snoring, snorting, or excessive daytime sleepiness. The BMI and NHHR were calculated based on height and weight measurements and laboratory data, respectively. Weighted multivariate logistic and linear regression analyses were conducted to examine the associations, and restricted cubic spline (RCS) analysis was used to assess dose–response relationships. Mediation analysis was performed to evaluate the NHHR’s role in the BMI–SDB association. Subgroup analyses were performed to assess differences across various populations. Results SDB symptoms were observed in 51.05% of participants. Higher BMI was significantly associated with increased SDB risk. RCS analysis revealed a nonlinear relationship between BMI and SDB. Subgroup analyses indicated a positive correlation between BMI and SDB was stronger among nonhypertensive participants. NHHR was positively associated with BMI and SDB. Mediation analysis showed that the NHHR explained 5.44–8.12% of the BMI–SDB association. Conclusions BMI is a critical factor in the risk of SDB, and the NHHR partially mediates this relationship. BMI and cholesterol levels should be managed to mitigate the SDB risk. Level of evidence Level V—cross-sectional observational study.
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spelling doaj-art-8dc3490185a245609a19ae5aaed7605d2025-02-09T12:04:44ZengSpringerEating and Weight Disorders1590-12622025-02-0130111510.1007/s40519-025-01717-4Exploring the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the association between obesity and sleep-disordered breathingYing Cui0Ziyi Cheng1Department of Public Health Science, Graduate School and Transdisciplinary Major in Learning Health Systems, Graduate School, Korea UniversityDepartment of Electrical and Electronic Engineering, The University of ManchesterAbstract Purpose Exploring novel mediators affecting the relationship between obesity and sleep-disordered breathing (SDB) is necessary. This study aimed to explore the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the association between body mass index (BMI) and SDB using data from the 2015–2018 National Health and Nutrition Examination Survey (NHANES) cycles. Methods Total 7639 participants were included. SDB was defined based on the self-reported frequency of snoring, snorting, or excessive daytime sleepiness. The BMI and NHHR were calculated based on height and weight measurements and laboratory data, respectively. Weighted multivariate logistic and linear regression analyses were conducted to examine the associations, and restricted cubic spline (RCS) analysis was used to assess dose–response relationships. Mediation analysis was performed to evaluate the NHHR’s role in the BMI–SDB association. Subgroup analyses were performed to assess differences across various populations. Results SDB symptoms were observed in 51.05% of participants. Higher BMI was significantly associated with increased SDB risk. RCS analysis revealed a nonlinear relationship between BMI and SDB. Subgroup analyses indicated a positive correlation between BMI and SDB was stronger among nonhypertensive participants. NHHR was positively associated with BMI and SDB. Mediation analysis showed that the NHHR explained 5.44–8.12% of the BMI–SDB association. Conclusions BMI is a critical factor in the risk of SDB, and the NHHR partially mediates this relationship. BMI and cholesterol levels should be managed to mitigate the SDB risk. Level of evidence Level V—cross-sectional observational study.https://doi.org/10.1007/s40519-025-01717-4Sleep-disordered breathingHigh-density lipoprotein cholesterol ratioBody mass indexRestricted cubic spline modelBoruta algorithm
spellingShingle Ying Cui
Ziyi Cheng
Exploring the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the association between obesity and sleep-disordered breathing
Eating and Weight Disorders
Sleep-disordered breathing
High-density lipoprotein cholesterol ratio
Body mass index
Restricted cubic spline model
Boruta algorithm
title Exploring the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the association between obesity and sleep-disordered breathing
title_full Exploring the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the association between obesity and sleep-disordered breathing
title_fullStr Exploring the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the association between obesity and sleep-disordered breathing
title_full_unstemmed Exploring the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the association between obesity and sleep-disordered breathing
title_short Exploring the mediating role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) in the association between obesity and sleep-disordered breathing
title_sort exploring the mediating role of the non high density lipoprotein cholesterol to high density lipoprotein cholesterol ratio nhhr in the association between obesity and sleep disordered breathing
topic Sleep-disordered breathing
High-density lipoprotein cholesterol ratio
Body mass index
Restricted cubic spline model
Boruta algorithm
url https://doi.org/10.1007/s40519-025-01717-4
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AT ziyicheng exploringthemediatingroleofthenonhighdensitylipoproteincholesteroltohighdensitylipoproteincholesterolrationhhrintheassociationbetweenobesityandsleepdisorderedbreathing