Age and sex-specific longitudinal effects of OSA on gray matter volume

초록

Introduction: Obstructive Sleep Apnea (OSA) has been associated withneurocognitive impairments and brain structural changes. However, theroles of age and sex in the volume changes in OSA remain unclear. Thisstudy aimed to investigate the age and sex‐dependent effects of OSA on8‐year gray matter (GM) volume changes in the Korean Genome and Epi-demiology Study (KoGES), the general population‐based cohort study.Method: Participants (n = 2335) underwent both polysomnography(PSG) and magnetic resonance imaging (MRI) at both baseline (2011–2014) and 8-year follow-up (2019–2022). AHI (Apnea HypopneaIndex) was used for categorizing groups: non OSA (AHI < 515 eventsh1 ), mild OSA (AHI 5–15 eventsh1 ), and moderate-severe OSA (AHI eventsh1) at baseline. The main outcome is 8 yearsGM volume changes of 4 lobes via voxel-based morphometry in rela-tionship with OSA severity by age and sex. Participants were groupedby age under 55, between 55 and 64, and older than 64.Results: Of the total participants (mean age, 58.4 [6.1], female = 1175), inmultivariable adjusted (education, body mass index, smoking, drinking,hypertension, diabetes, cardiovascular disease, and estimated total intracra-nial volume) linear regression, at aged over 64, women with both mild andmoderate-severe OSA had significant total GM volume decline (β = 4.8,[SE 2.1] mL, p = 0.02 and β = 6.0 [SE 2.7] mL, p = 0.03, respectively)compared to non-OSA group. Specifically, the difference was observed inthe parietal lobe (β = 1.7 [SE 0.8] mL, p = 0.04 and β = 2.5 [SE 1.0]mL, p = 0.02). However, no significant decline in men was observed.Conclusion: This study found significant GM volume decline in elderlywomen with OSA severity in a dose response pattern independent ofconfounding factors.