Background

There is emerging evidence that severe OSA predicts dyslipidemia in adults, yet, few studies have analyzed this association in adolescents. The aim of this study is to assess if severe OSA predicts abnormal lipid levels in adolescents with severe obesity, who represent a high-risk population.

Methods

A cross-sectional study of 72 adolescents (58% female, 57% Black, 37% White, 6% other race), with mean age 15.0 ± 1.4 years and mean BMI 53.3 ± 8.9 kg/m2, was conducted. Adolescents were admitted to a pediatric hospital for a battery of diagnostic tests, which included a polysomnogram (PSG) and fasting lipid panel, as part of routine care for severe obesity. Demographic (sex, race, age), BMI, PSG, and lipid data were obtained from the EHR. Age and BMI were categorized as above and below the mean. Severe OSA was defined as having an apnea-hypopnea index (AHI) ≥ 10 (N=30). NHLBI guidelines were used to define abnormal lipid levels: Total Cholesterol (TC) ≥ 200 mg/dL (N=9), Triglycerides ≥ 130 mg/dL (N=17), HDL < 40 mg/dL (N=43), LDL ≥ 130 mg/dL (N=11). The associations between abnormal lipid levels, severe OSA, BMI, and demographics were assessed by Chi-Square analyses. The association between severe OSA and abnormal lipid levels, adjusted for demographics and BMI, was analyzed by logistic regression.

Results

Severe OSA was associated with high TC (X2(1) = 9.4, p=0.002) and LDL levels (X2(1) = 8.6, p=0.003), but not with triglycerides or HDL. After adjusting for demographics and BMI, adolescents with severe OSA were 16.7 times more likely (95% CI 1.86-150.25) to have high TC levels and 9.2 times more likely (95% CI 1.65-51.70) to have high LDL levels compared to peers without severe OSA.

Conclusions

Severe OSA independently predicts abnormal TC and LDL levels in adolescents with severe obesity. More studies are needed to understand the physiology behind this association and to assess if OSA treatment impacts lipid levels and future cardiovascular risk.