Association between the atherogenic index of plasma and high risk of obstructive sleep apnea in aged person over 60: A cross-sectional analysis based on NHANES 2017 to 2020

This study aimed to investigate the association between the atherogenic index of plasma (AIP) and the high risk of obstructive sleep apnea (OSA) in aged person over 60 years, utilizing data from the National Health and Nutrition Examination Survey 2017 to 2020. A cross-sectional analysis was performed on 903 elderly participants from National Health and Nutrition Examination Survey. OSA risk was assessed using a modified STOP-Bang questionnaire. AIP was calculated as log10 (triglycerides/high-density lipoprotein cholesterol). Multivariable logistic regression models adjusted for demographics, lifestyle, and comorbidities were used to evaluate the AIP-OSA association. Subgroup analyses explored effect modifications by age, race, smoking, alcohol use, diabetes, and education. Sensitivity analyses, including quartile-based trend tests, were performed to assess the robustness of the findings. Restricted cubic splines explored potential nonlinear associations between AIP and OSA. Compared to the non-OSA High Risk Group (n = 533), the OSA High Risk group (n = 370) had significantly higher AIP (P < .05). In fully adjusted models, each 1-unit AIP increase raised OSA risk by 87% (OR = 1.87, 95% CI: 1.17-3.00, P = .0097). Subgroup analyses revealed stronger associations in individuals aged < 70 (OR = 2.50, P = .0045), alcohol consumers (OR = 2.21, P = .0019), non-diabetics (OR = 2.37, P = .0027), and non-Hispanic Black participants (OR = 5.93, P = .0014). Restricted cubic splines confirmed a linear relationship (P-overall = .0269, P-nonlinear = .471). Sensitivity analyses further supported the robustness of these findings. Elevated AIP is independently associated with a higher risk of OSA in older adults. AIP may serve as a potential biomarker for OSA risk stratification in this population.