Association of inflammation-related biomarkers with the risk of obstructive sleep apnea among senior adults: a prospective cohort study.

OBJECTIVE: This study aimed to examine the association between six common inflammation-related biomarkers and obstructive sleep apnea (OSA) incidence in a prospective cohort. METHODS: 2633 participants aged ≥60 years and without OSA were selected from the baseline survey of Guangzhou Heart Study, conducted in 2015-2017. The follow-up survey was conducted in 2018-2019. OSA was evaluated using Berlin Questionnaire in each survey. Six inflammation-related biomarkers, including uric acid, C-reactive protein (CRP), bilirubin, systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), were detected or calculated. Odds ratio (OR) with a 95% confidence interval (CI) was estimated using logistic regression model. RESULTS: 379 (14.4%) new cases of OSA were identified during a median of 31.13 months of follow-up. When comparing the highest and lowest quartiles, bilirubin was associated with a 38% increased risk of OSA (OR: 1.43, 95% CI: 1.04 - 1.96) after adjustment for potential confounders. In stratified analysis, when comparing the highest with lowest quartiles and after adjustment for confounders, bilirubin was associated with 1.71-fold (95% CI: 1.15 - 2.53) risk of OSA among females and 1.57-fold (95% CI: 1.02 - 2.42) risk of OSA among the older aged more than 68 years, and CRP was associated with 2.61-fold (95% CI: 1.29 - 5.32) risk of OSA among males. No significant association was found between other four biomarkers and OSA risk. CONCLUSIONS: A higher level of serum bilirubin was associated with an increased risk of OSA. Bilirubin may be a biomarker for precise prevention and treatment of OSA.