ORIGINAL RESEARCH article
Front. Neurol.
Sec. Sleep Disorders
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1594875
Correlation between obstructive sleep apnea and TG/HDL-C Ratio in the adult US population: a cross-sectional study
Provisionally accepted- The Centre Hospital of Wuhan, Wuhan, China
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Obstructive sleep apnea (OSA) is associated with dyslipidemia, neurocognitive impairment, and cardiovascular morbidity. This study investigates the triglyceride-tohigh-density lipoprotein cholesterol ratio (TG/HDL-C) as a composite biomarker for OSA prevalence, with implications for mitigating OSA-associated complications through metabolic modulation.A nationally representative cohort of 3,270 adults (NHANES 2015-2018) was analyzed using weighted multivariate logistic regression. Restricted cubic splines (RCS) modeled nonlinear associations, while receiver operating characteristic (ROC) curves evaluated predictive performance against conventional lipid indices (TG, HDL-C, NHHR). The DeLong test further compares the predictive efficacy between models. The differences between groups in predicting OSA based on TG/HDL-C levels were further examined via subgroup analysis.Significant differences in lipid profiles were observed between OSA and non-OSA cohorts (P< 0.01). Each unit increase in TG/HDL-C conferred a 17% elevated OSA risk [OR = 1.17; 95% CI: 1.00-1.35; P=0.045], with a nonlinear dose-response relationship (P for nonlinear=0.017). TG/HDL-C demonstrated superior predictive accuracy (AUC=0.589) versus NHHR (AUC=0.572). Subgroup analyses indicated that TG/HDL-C as an indicator of OSA varied by the family income to poverty ratio(PIR)group, as well as among congestive heart failure and angina populations (P for interaction< 0.05).This study demonstrates that the TG/HDL-C ratio is a superior predictor of OSA risk compared to TG and NHHR. These findings underscore the clinical utility of composite lipid indices TG/HDL-C for early OSA detection and targeted intervention.
Keywords: NHANES, obstructive sleep apnea, TG/HDL-C NHANES, TG/HDL-C, Dyslipidemia
Received: 18 Mar 2025; Accepted: 02 Jun 2025.
Copyright: © 2025 Yang, Wu and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yanlin Yang, The Centre Hospital of Wuhan, Wuhan, China
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