Effect of the Interaction between Obstructive Sleep Apnea and Lipoprotein(a) on Insulin Resistance: A Large-Scale Cross-Sectional Study

Both obstructive sleep apnea (OSA) and decreased serum lipoprotein(a) (Lp(a)) concentrations are associated with insulin resistance. However, their interaction effect on insulin resistance has never been investigated. Therefore, we performed a cross-sectional study on OSA-suspected Chinese Han parti...

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Main Authors: Yupu Liu, Juanjuan Zou, Xinyi Li, Xiaolong Zhao, Jianyin Zou, Suru Liu, Lili Meng, Yingjun Qian, Huajun Xu, Hongliang Yi, Jian Guan, Shankai Yin
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2019/9583286
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author Yupu Liu
Juanjuan Zou
Xinyi Li
Xiaolong Zhao
Jianyin Zou
Suru Liu
Lili Meng
Yingjun Qian
Huajun Xu
Hongliang Yi
Jian Guan
Shankai Yin
author_facet Yupu Liu
Juanjuan Zou
Xinyi Li
Xiaolong Zhao
Jianyin Zou
Suru Liu
Lili Meng
Yingjun Qian
Huajun Xu
Hongliang Yi
Jian Guan
Shankai Yin
author_sort Yupu Liu
collection DOAJ
description Both obstructive sleep apnea (OSA) and decreased serum lipoprotein(a) (Lp(a)) concentrations are associated with insulin resistance. However, their interaction effect on insulin resistance has never been investigated. Therefore, we performed a cross-sectional study on OSA-suspected Chinese Han participants. Laboratory-based polysomnographic variables, biochemical indicators, anthropometric measurements, and medical history were collected. Linear regression and binary logistic regression analyses with interaction terms were used to investigate the potential effects of the interaction between the severity of OSA (assessed by the apnea-hypopnea index (AHI)) and Lp(a) concentrations on insulin resistance (assessed by the homeostasis model assessment of insulin resistance (HOMA-IR)), after adjusting for potential confounders including age, gender, body mass index, waist-to-hip circumference ratio, mean arterial pressure, smoking status, drinking status, and lipid profiles. A total of 4,152 participants were enrolled. In the OSA-suspected population, AHI positively correlated with insulin resistance and serum Lp(a) concentrations independently and inversely correlated with insulin resistance. In addition, the interaction analysis showed that the linear association between lgAHI and lgHOMA-IR was much steeper and more significant in subjects with relatively low Lp(a) concentrations, suggesting a significant positive interaction between lgLp(a) and lgAHI on lgHOMA-IR (P=0.013). Furthermore, the interaction on a multiplicative scale also demonstrated a significant positive interaction (P=0.044). A stronger association between AHI quartiles and the presence of insulin resistance (defined as HOMA-IR > 3) could be observed for participants within lower Lp(a) quartiles. In conclusion, a significant positive interaction was observed between OSA and decreased Lp(a) with respect to insulin resistance. This association might be relevant to the assessment of metabolic or cardiovascular disease risk in OSA patients.
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spelling doaj-art-e5950eb03b534cf683142dcebf03965e2025-08-20T02:21:19ZengWileyJournal of Diabetes Research2314-67452314-67532019-01-01201910.1155/2019/95832869583286Effect of the Interaction between Obstructive Sleep Apnea and Lipoprotein(a) on Insulin Resistance: A Large-Scale Cross-Sectional StudyYupu Liu0Juanjuan Zou1Xinyi Li2Xiaolong Zhao3Jianyin Zou4Suru Liu5Lili Meng6Yingjun Qian7Huajun Xu8Hongliang Yi9Jian Guan10Shankai Yin11Department of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaDepartment of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaDepartment of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaDepartment of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaDepartment of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaDepartment of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaDepartment of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaDepartment of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaDepartment of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaDepartment of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaDepartment of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaDepartment of Otolaryngology, Therapy Center for Obstructive Sleep Apnea, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Xuhui District, Shanghai 200233, ChinaBoth obstructive sleep apnea (OSA) and decreased serum lipoprotein(a) (Lp(a)) concentrations are associated with insulin resistance. However, their interaction effect on insulin resistance has never been investigated. Therefore, we performed a cross-sectional study on OSA-suspected Chinese Han participants. Laboratory-based polysomnographic variables, biochemical indicators, anthropometric measurements, and medical history were collected. Linear regression and binary logistic regression analyses with interaction terms were used to investigate the potential effects of the interaction between the severity of OSA (assessed by the apnea-hypopnea index (AHI)) and Lp(a) concentrations on insulin resistance (assessed by the homeostasis model assessment of insulin resistance (HOMA-IR)), after adjusting for potential confounders including age, gender, body mass index, waist-to-hip circumference ratio, mean arterial pressure, smoking status, drinking status, and lipid profiles. A total of 4,152 participants were enrolled. In the OSA-suspected population, AHI positively correlated with insulin resistance and serum Lp(a) concentrations independently and inversely correlated with insulin resistance. In addition, the interaction analysis showed that the linear association between lgAHI and lgHOMA-IR was much steeper and more significant in subjects with relatively low Lp(a) concentrations, suggesting a significant positive interaction between lgLp(a) and lgAHI on lgHOMA-IR (P=0.013). Furthermore, the interaction on a multiplicative scale also demonstrated a significant positive interaction (P=0.044). A stronger association between AHI quartiles and the presence of insulin resistance (defined as HOMA-IR > 3) could be observed for participants within lower Lp(a) quartiles. In conclusion, a significant positive interaction was observed between OSA and decreased Lp(a) with respect to insulin resistance. This association might be relevant to the assessment of metabolic or cardiovascular disease risk in OSA patients.http://dx.doi.org/10.1155/2019/9583286
spellingShingle Yupu Liu
Juanjuan Zou
Xinyi Li
Xiaolong Zhao
Jianyin Zou
Suru Liu
Lili Meng
Yingjun Qian
Huajun Xu
Hongliang Yi
Jian Guan
Shankai Yin
Effect of the Interaction between Obstructive Sleep Apnea and Lipoprotein(a) on Insulin Resistance: A Large-Scale Cross-Sectional Study
Journal of Diabetes Research
title Effect of the Interaction between Obstructive Sleep Apnea and Lipoprotein(a) on Insulin Resistance: A Large-Scale Cross-Sectional Study
title_full Effect of the Interaction between Obstructive Sleep Apnea and Lipoprotein(a) on Insulin Resistance: A Large-Scale Cross-Sectional Study
title_fullStr Effect of the Interaction between Obstructive Sleep Apnea and Lipoprotein(a) on Insulin Resistance: A Large-Scale Cross-Sectional Study
title_full_unstemmed Effect of the Interaction between Obstructive Sleep Apnea and Lipoprotein(a) on Insulin Resistance: A Large-Scale Cross-Sectional Study
title_short Effect of the Interaction between Obstructive Sleep Apnea and Lipoprotein(a) on Insulin Resistance: A Large-Scale Cross-Sectional Study
title_sort effect of the interaction between obstructive sleep apnea and lipoprotein a on insulin resistance a large scale cross sectional study
url http://dx.doi.org/10.1155/2019/9583286
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