Association between obstructive sleep apnea and metabolic abnormalities in patients with hypertrophic cardiomyopathy

Objectives Metabolic abnormalities have been associated with long-term cardiac mortality in patients with hypertrophic cardiomyopathy (HCM). Obstructive sleep apnea (OSA) is a risk factor for metabolic abnormalities in general populations, but association between OSA and metabolic abnormalities in HCM is still undefined. This study aimed to investigate the relationship between OSA and metabolic dysfunction in a large series of patients with HCM. Methods A total of 587 patients with HCM who underwent sleep evaluations at Fuwai Hospital were included. Data from clinical characteristics, polysomnography studies and metabolic measurements were collected. Results OSA was present in 344 patients (58.6%). Patients with OSA were older, more often male and had more clinical comorbidities. Body mass index, blood pressure, fasting glucose and triglycerides all increased (all P<0.001) and high-density lipoprotein cholesterol decreased (P=0.046) with the severity of OSA. In multivariate analysis, moderate to severe OSA and Log (AHI[apnea-hypopnea index]+1) were independently associated with obesity (OR, 2.42; 95%CI [1.48–3.95] and OR, 1.60; 95%CI [1.31–1.95]), elevated blood pressure (OR, 1.99; 95%CI [1.42–3.26] and OR, 1.31; 95%CI [1.08–1.60]) and elevated triglycerides (OR, 1.71; 95%CI [1.05–2.78] and OR, 1.24; 95%CI [1.02–1.51] but not elevated fasting glucose (OR, 0.88; 95%CI [0.50–1.52] and OR, 1.02; 95%CI [0.82–1.28]) and reduced high-density lipoprotein cholesterol (OR, 1.30; 95%CI [0.83–2.04] and OR, 1.06; 95%CI [0.89–1.27]). Conclusions Severity of OSA is independently associated with some profiles of metabolic abnormalities. Clinical trials are required to determine whether OSA treatment improves metabolic abnormalities and long-term outcomes in patients with HCM.