TY - JOUR T1 - Obstructive sleep apnoea treatment and fasting lipids: a comparative effectiveness study JF - European Respiratory Journal JO - Eur Respir J SP - 405 LP - 414 DO - 10.1183/09031936.00043614 VL - 44 IS - 2 AU - Brendan T. Keenan AU - Greg Maislin AU - Bernie Y. Sunwoo AU - Erna Sif Arnardottir AU - Nicholas Jackson AU - Isleifur Olafsson AU - Sigurdur Juliusson AU - Richard J. Schwab AU - Thorarinn Gislason AU - Bryndis Benediktsdottir AU - Allan I. Pack Y1 - 2014/08/01 UR - http://erj.ersjournals.com/content/44/2/405.abstract N2 - Obstructive sleep apnoea (OSA) is associated with cardiovascular disease. Dyslipidaemia has been implicated as a mechanism linking OSA with atherosclerosis, but no consistent associations with lipids exist for OSA or positive airway pressure treatment. We assessed the relationships between fasting lipid levels and obesity and OSA severity, and explored the impact of positive airway pressure treatment on 2-year fasting lipid level changes. Analyses included moderate-to-severe OSA patients from the Icelandic Sleep Apnoea Cohort. Fasting morning lipids were analysed in 613 untreated participants not on lipid-lowering medications at baseline. Patients were then initiated on positive airway pressure and followed for 2 years. Sub-classification using propensity score quintiles, which aimed to replicate covariate balance associated with randomised trials and, therefore, minimise selection bias and allow causal inference, was used to design the treatment group comparisons. 199 positive airway pressure adherent patients and 118 non-users were identified. At baseline, obesity was positively correlated with triglycerides and negatively correlated with total cholesterol, and low-density and high-density lipoprotein cholesterol. A small correlation was observed between the apnoea/hypopnoea index and high-density lipoprotein cholesterol. No effect of positive airway pressure adherence on 2-year fasting lipid changes was observed. Results do not support the concept of changes in fasting lipids as a primary mechanism for the increased risk of atherosclerotic cardiovascular disease in OSA. Fasting lipid changes are unaffected by positive airway pressure and thus don’t increase cardiovascular risk http://ow.ly/vSEdq ER -