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

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.