Highlights
- •We examine the association between OSA severity and abdominal aortic calcification.
- •Abdominal aortic calcification increases in severe OSA.
- •Traditional risk factors are more potent to increase aortic calcification than OSA.
- •OSA may enhance atherosclerosis mainly through comorbid cardiometabolic disorders.
Abstract
Background
No studies have addressed the relationship between obstructive sleep apnea (OSA) and
abdominal aortic calcification (AAC), a marker for subclinical atherosclerosis and
future cardiovascular events.
Objectives
To investigate 1) the association between OSA severity and AAC, and 2) whether OSA
can impact the extent of AAC independent of comorbid atherogenic risk factors.
Methods
390 participants aged 40–70 years underwent polysomnography and abdominal computed
tomography. AAC was separately quantified in the upper and lower abdominal aorta using
the modified Agatston scoring method, and the total AAC score was calculated as a
sum of the two scores. OSA was defined as none/mild (apnea-hypopnea index [AHI] <15,
n = 87), moderate (AHI 15–30, n = 129), and severe (AHI ≥30, n = 174).
Results
Log-transformed total AAC score adjusted for age and body mass index (BMI) was greater
in participants with an elevated AHI (3.4 for none/mild OSA, 3.7 for moderate OSA,
and 4.2 for severe OSA, p = 0.04). Multivariate linear regression analysis including
age and BMI as covariates showed that severe OSA was associated with higher scores
for the lower and total AAC (β = 0.15 and 0.14, p = 0.01 and 0.01, respectively).
The association did not persist after additionally adjusting for traditional atherogenic
risk factors including visceral fat, smoking, hypertension, dyslipidemia, and diabetes.
Conclusions
Severe OSA was associated with a greater extent of AAC, which was dependent on coexisting
atherogenic risk factors. Comorbid cardiometabolic disorders may largely mediate the
association of OSA with subclinical atherosclerosis.
Keywords
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Article Info
Publication History
Published online: April 26, 2015
Accepted:
April 22,
2015
Received in revised form:
March 23,
2015
Received:
January 7,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
