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Lin M, Abuduxukuer K, Ye L, Zhang H, Zhang X, Shi S, Wang Y, Liu Y. Association Between the Nutritional Inflammatory Index and Obstructive Sleep Apnea Risk: Insights from the NHANES 2015-2020 and Mendelian Randomization Analyses. Healthcare (Basel) 2025; 13:783. [PMID: 40218080 PMCID: PMC11988625 DOI: 10.3390/healthcare13070783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2025] [Revised: 03/14/2025] [Accepted: 03/28/2025] [Indexed: 04/14/2025] Open
Abstract
Background/Objectives: Current approaches to monitoring obstructive sleep apnea (OSA) risk primarily focus on structural or functional abnormalities, often neglecting systemic metabolic and physiological factors. Resource-intensive methods, such as polysomnography (PSG), limit their routine applicability. This study aimed to evaluate composite nutritional-inflammatory indices derived from routine blood markers to identify feasible indices for OSA management and explore their association with OSA risk. Methods: Data from 9622 adults in the NHANES (2015-2020) and GWAS datasets were analyzed using logistic regression, restricted cubic splines, machine learning, and Mendelian randomization (MR). These techniques were employed to identify nutritional-inflammatory indices associated with OSA risk. Random forest modeling identified body mass index (BMI) and albumin (ALB) as key components of the advanced lung cancer inflammation index (ALI). Causal relationships between ALI components and OSA were validated using MR. Results: ALI was significantly associated with OSA, with individuals in the highest ALI tertile exhibiting a 59% higher likelihood of OSA (OR = 1.59, 95% CI: 1.38-1.84; p < 0.001). BMI and ALB were identified as key contributors to ALI and confirmed as causal risk factors for OSA (BMI: OR = 1.91, 95% CI: 1.80-2.02; ALB: OR = 1.11, 95% CI: 1.04-1.19). Age, gender, and the neutrophil-to-lymphocyte ratio (NLR) were also significant predictors. Conclusions: This study identifies ALI as a potential composite index for assessing OSA risk. Integrating statistical modeling, machine learning, and causal inference techniques highlights the utility of nutritional-inflammatory indices in improving OSA monitoring and management in clinical practice.
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Affiliation(s)
- Meixiu Lin
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai 200001, China; (M.L.); (L.Y.); (X.Z.); (S.S.)
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai 200001, China;
| | - Kaiweisa Abuduxukuer
- Department of Preventive Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai 200001, China;
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China
| | - Lisong Ye
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai 200001, China; (M.L.); (L.Y.); (X.Z.); (S.S.)
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai 200001, China;
| | - Hao Zhang
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai 200001, China;
- Department of Preventive Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai 200001, China;
| | - Xin Zhang
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai 200001, China; (M.L.); (L.Y.); (X.Z.); (S.S.)
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai 200001, China;
| | - Shuangshuang Shi
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai 200001, China; (M.L.); (L.Y.); (X.Z.); (S.S.)
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai 200001, China;
| | - Yan Wang
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai 200001, China;
- Department of Preventive Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai 200001, China;
| | - Yuehua Liu
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai 200001, China; (M.L.); (L.Y.); (X.Z.); (S.S.)
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai 200001, China;
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Nag DS, Varghese K, Swain A, Patel R, Sahu S, Sam M. Update on the aetiopathogenesis of obstructive sleep apnea: Role of inflammatory and immune mediated mechanisms. World J Clin Cases 2024; 12:6754-6759. [PMID: 39687652 PMCID: PMC11525906 DOI: 10.12998/wjcc.v12.i35.6754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 08/19/2024] [Accepted: 09/09/2024] [Indexed: 10/24/2024] Open
Abstract
Obstructive sleep apnea (OSA) is often a lifestyle disease associated with obesity, which is rapidly evolving as a major health concern with diverse multisystemic implications. To prevent and mitigate its adverse effects and reduce its burden on society, its aetiopathogeneses must be precisely understood. Numerous studies focusing on the range of diverse anatomic, functional, and lifestyle factors have already been carried out to determine the possible contributory roles of these factors in OSA. Recently, evidence to validate the role of inflammatory pathways and immune mechanisms in the aetiopathogeneses of OSA is being developed. This allows for further research and translation of such knowledge for targeted therapeutic and preventive interventions in patients with or who are at risk of developing OSA.
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Affiliation(s)
- Deb Sanjay Nag
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
| | - Koshy Varghese
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
| | - Amlan Swain
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
- Department of Anaesthesiology, Manipal Tata Medical College, Jamshedpur 831017, India
| | - Roushan Patel
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
- Department of Anaesthesiology, Manipal Tata Medical College, Jamshedpur 831017, India
| | - Seelora Sahu
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
- Department of Anaesthesiology, Manipal Tata Medical College, Jamshedpur 831017, India
| | - Merina Sam
- Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, Jharkhand, India
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Ali M, Ramadan A, Surani S. Obstructive sleep apnea-hypopnea syndrome immunological relationship. World J Clin Cases 2024; 12:6011-6014. [PMID: 39328853 PMCID: PMC11326110 DOI: 10.12998/wjcc.v12.i27.6011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/31/2024] [Accepted: 06/14/2024] [Indexed: 07/29/2024] Open
Abstract
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a complex disorder characterized by symptoms resulting from intermittent hypoxia and hypopnea, with research indicating a crucial role of immune system dysregulation and genetic variations in its pathogenesis. A recent Zhao et al study utilizes Mendelian randomization analysis to explore the causal relationship between immune cell characteristics and OSAHS. The study identifies specific lymphocyte subsets associated with OSAHS, providing valuable insights into the disease's pathophysiology and potential targets for therapeutic intervention. The findings underscore the significance of genetic and immunological factors in sleep disorders, offering a fresh perspective on OSAHS's complexities. Compared to existing literature, Zhao et al's study stands out for its focus on genetic markers and specific immune responses associated with OSAHS, expanding upon previous research primarily centered on systemic inflammation. In conclusion, the study represents a significant advancement in the field, shedding light on the causal role of immune cells in OSAHS and paving the way for future research and targeted treatments.
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Affiliation(s)
- Mahmoud Ali
- Department of Medicine, Al-Azhar University, Damietta 11651, Egypt
| | - Alaa Ramadan
- Department of Medicine, South Valley University, Qena 83523, Egypt
| | - Salim Surani
- Department of Medicine and Pharmacology, Texas A&M University, College Station, TX 77843, United States
- Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States
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