BACKGROUND: Obstructive sleep apnea (OSA) activates several pathophysiological mechanisms which can lead to the development of vascular diseases. Endothelial dysfunction (ED) is an initial step in the development of atherosclerosis. The association between ED and OSA has been described in several studies, even in previously healthy subjects. High-density lipoproteins (HDL) were generally considered to be atheroprotective, and low-density lipoprotein (LDL) to be an atherogenic component of lipoproteins. However, recent findings suggest a pro-atherogenic role of small HDL subfractions (8-10) and LDL subfractions (3-7). This study aimed to evaluate the relationship between endothelial function and lipid subfractions in previously healthy OSA subjects. MATERIAL AND METHODS: We prospectively enrolled 205 subjects with sleep monitoring. Plasma levels of triacylglycerols, total cholesterol, LDL, HDL, and their subfractions were assessed. Endothelial function was determined using peripheral arterial tonometry, and reperfusion hyperemia index (RHI) was assessed. RESULTS: Plasma levels of small and intermediate HDL subfractions have statistically significant pro-atherogenic correlations with endothelial function (p = 0.015 and p = 0.019). In other lipoprotein levels, no other significant correlation was found with RHI. In stepwise multiple linear regression analysis, small HDL (beta = -0.507, p = 0.032) was the only significant contributor in the model predicting RHI. CONCLUSIONS: In our studied sample, a pro-atherogenic role of small HDL subfractions in previously healthy subjects with moderate-to-severe OSA was proven.

1st Department of Neurology Faculty of Medicine Comenius University University Hospital 81499 Bratislava Slovakia

Department of ENT and HNS Faculty of Medicine Comenius University University Hospital 81499 Bratislava Slovakia

Department of Neurology General Hospital 03123 Liptovsky Mikulas Slovakia

Department of Neurology University Hospital Bratislava 85107 Bratislava Slovakia

Department of Otorhinolaryngology University Hospital in Pilsen Faculty of Medicine Charles University 11000 Pilsen Czech Republic

Department of Pediatric Otorhinolaryngology University Hospital Brno 61300 Brno Czech Republic

Faculty of Medicine Masaryk University 62500 Brno Czech Republic

Institute of Cancer and Genomic Sciences University of Birmingham Birmingham B15 2SQ UK

Institute of Medical Chemistry Biochemistry and Clinical Biochemistry Faculty of Medicine Comenius University 81499 Bratislava Slovakia

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