RT Journal Article SR Electronic T1 Obstructive sleep apnoea treatment and fasting lipids: a comparative effectiveness study JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 405 OP 414 DO 10.1183/09031936.00043614 VO 44 IS 2 A1 Brendan T. Keenan A1 Greg Maislin A1 Bernie Y. Sunwoo A1 Erna Sif Arnardottir A1 Nicholas Jackson A1 Isleifur Olafsson A1 Sigurdur Juliusson A1 Richard J. Schwab A1 Thorarinn Gislason A1 Bryndis Benediktsdottir A1 Allan I. Pack YR 2014 UL http://erj.ersjournals.com/content/44/2/405.abstract AB 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