Obstructive sleep apnea is associated with disturbances in nutrition-related biochemical markers among eutrophic adults: Findings from the EPISONO cohort

BACKGROUND: Although obstructive sleep apnea (OSA) is strongly linked to obesity, less is known about nutritional and biochemical alterations among eutrophic individuals with the disorder. This study aimed to evaluate nutrition-related biochemical markers in eutrophic adults living in São Paulo and examine their association with OSA severity. METHODS: This cross-sectional analysis used data from the 4th edition of the EPISONO, a population-based study. Participants underwent polysomnography, blood sample analysis, and lifestyle questionnaires. RESULTS: From an initial sample of 769 participants, 23.9% were eutrophic adults aged 20-59 years. Participants were classified as no OSA, mild OSA, or moderate-to-severe OSA. The Kruskal-Wallis test and generalized linear models (GzLM) were applied. Individuals with moderate-to-severe OSA exhibited higher concentrations of very-low density lipoprotein (VLDL) and triglycerides compared with those without OSA, while zinc levels differed across OSA severity groups. In the total sample, higher apnea-hypopnea index (AHI) values were independently associated with higher VLDL and triglyceride levels and lower magnesium concentrations after full adjustment. Sex-stratified analyses revealed that lipid markers and zinc were linked to AHI in women, whereas magnesium was inversely associated with AHI in men. CONCLUSIONS: These findings suggest that metabolic and nutrition-related differences may coexist with OSA even in individuals within the eutrophic range and may exhibit distinct sex-specific patterns.