{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T13:29:24Z","timestamp":1787146164266,"version":"build-2736575974"},"reference-count":36,"publisher":"Walter de Gruyter GmbH","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The association between accelerated biological aging and sleep apnea remains unclear. This study aimed to investigate the association of phenotypic aging (PhenoAge) with sleep apnea, identify nonlinear patterns and high-risk subgroups, and explore metabolic-oxidative stress (as measured by uric acid-to-HDL ratio, UHR) as a potential mediator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a cross-sectional analysis of 4,901 adults from NHANES 2005\u20132008, sleep apnea was self-reported. PhenoAge was calculated from clinical biomarkers. Associations were assessed using multivariable logistic regression and restricted cubic splines; potential mediation by UHR was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Each 1-year increase in PhenoAge was associated with a 3% higher odds of sleep apnea (OR=1.03, 95% CI: 1.01\u20131.04). A statistically derived nonlinear inflection point at a PhenoAge of 44.09 years was observed. The association was significant only in adults \u226540 years (\n                      <jats:italic>P<\/jats:italic>\n                      -interaction=0.001) and was strongest in males and individuals with obesity. UHR accounted for 6.27% of the association, primarily in adults \u226540 years and individuals with obesity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cross-sectional study, accelerated biological aging, measured by PhenoAge, was associated with sleep apnea in a dose-dependent and age-delimited manner, with a statistical inflection point at 44.09 years. The modest association via UHR suggests oxidative-metabolic dysregulation as one potential explanatory factor. These exploratory findings provide a framework for hypothesis generation regarding the role of biological aging in sleep apnea.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/rjim-2026-0010","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T15:06:47Z","timestamp":1779116807000},"source":"Crossref","is-referenced-by-count":0,"title":["Accelerated Biological Aging and a Nonlinear Risk Threshold for Sleep Apnea: Evidence from NHANES and Mediation by Oxidative-Metabolic Dysregulation"],"prefix":"10.2478","author":[{"given":"Jia","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Beijing Friendship Hospital , Capital Medical University , , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaona","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Beijing Friendship Hospital , Capital Medical University , , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranran","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Beijing Friendship Hospital , Capital Medical University , , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"2026081913080265155_j_rjim-2026-0010_ref_001","doi-asserted-by":"crossref","unstructured":"THEORELL-HAGL\u00d6W J., MILLER CB., BARTLETT DJ., YEE BJ., OPENSHAW HD., GRUNSTEIN RR. 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