Association Between Obstructive Sleep Apnea and Prostate Cancer: NHANES and the Mendelian Randomization Study

Ying Liu,1,2,* Binglei Jiang,3,* Long Xia,2,* Erhao Bao,4 Li Wang,5 Ping-Yu Zhu2 1Department of Transfusion, Zigong First People’s Hospital, Zigong, Sichuan, People’s Republic of China; 2Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China; 3Department of Ultrasound, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People’s Republic of China; 4Department of Urology, Sichuan Provincial People’s Hospital East Sichuan Hospital & Dazhou First People’s Hospital, Dazhou, Sichuan, People’s Republic of China; 5Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ping-Yu Zhu, Email [email protected]: Obstructive sleep apnea is a common condition worldwide, and prostate cancer is the most prevalent cancer among men. However, the link between OSA and prostate cancer remains unclear. This study aims to explore the relationship between OSA and prostate cancer.Methods: Initially, a multivariable regression analysis was conducted to control for potential confounders and assess the impact of OSA on the risk of developing prostate cancer. Subsequently, age-stratified analyses were performed to further investigate the relationship between OSA and prostate cancer across different age groups. Finally, Mendelian randomization was employed to evaluate the causal relationship between OSA and prostate cancer risk.Results: The multivariable regression analysis of the NHANES data showed no significant association between OSA and prostate cancer after controlling for age, smoking habits, hypertension, diabetes, cardiovascular diseases, stroke, alcohol consumption, body mass index (OR = 0.83; 95% CI: 0.46– 1.48; p = 0.49). However, age-stratified analysis revealed a significant negative correlation between OSA and prostate cancer in the younger population (< 60 years) (OR = 0.07; 95% CI: 0.01– 0.74; p = 0.03), whereas no significant association was found in the elderly population (≥ 60 years) (OR = 1.01; 95% CI: 0.69– 1.49; p = 0.96). Finally, our Mendelian randomization results did not find a causal relationship between OSA and prostate cancer (OR = 0.992; 95% CI: 0.876– 1.124; p = 0.906).Conclusion: The findings indicate that while there is no significant association between OSA and prostate cancer in the overall analysis, a significant negative correlation exists in the younger population. The lack of significant association in the Mendelian randomization analysis may be due to the inability to perform age stratification. Further prospective studies and mechanistic research are needed to better understand the biological mechanisms underlying this association.Keywords: obstructive sleep apnea, prostate cancer, national health and nutrition examination survey, mendelian randomization