Sleep apnea and galectin-3: possible sex-specific relationship



Sleep apnea is associated with increased risk of cardiovascular disease. Elevated plasma galectin-3 levels, a biomarker associated with myocardial fibrosis, are also associated with adverse cardiovascular events, including heart failure. Our objective was to determine the relationship between severity of sleep apnea and plasma levels of galectin-3 and to determine whether this relationship was modified by sex.


We performed a cross-sectional study of 471 Mexican Americans from Starr County, TX who underwent an overnight, in-home sleep evaluation, and plasma measurement of galectin-3. Severity of sleep apnea was based on apnea hypopnea index (AHI). Multivariable linear regression modeling was used to determine the association between categories of sleep apnea and galectin-3. We also tested for interactions by sex.


The mean age was 53 years, and 74% of the cohort was female. The prevalence of moderate to severe sleep apnea (AHI > 15 apnea–hypopnea events per hour) was 36.7%. Moderate to severe sleep apnea was associated with increased levels of galectin-3 in the entire population, but we identified a statistically significant interaction between galectin-3 levels and category of sleep apnea by sex (p for interaction = 0.02). Plasma galectin levels were significantly higher in women with moderate or severe sleep apnea than women with no/mild sleep apnea (multivariable adjusted p < 0.001), but not in men (p = 0.5).


Sleep apnea is associated elevated galectin-3 levels in women but not men. Our findings highlight a possible sex-specific relationship between sleep apnea and galectin-3, a biomarker of potential myocardial fibrosis that has been associated with increased cardiovascular risk.

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Fig. 1



Apnea hypopnea index


Continuous positive airway pressure


Oxygen desaturation index


Time spent (minutes) below nocturnal oxygen saturation of 90%


High-sensitivity troponin-T


N-terminal pro-B-type natriuretic peptide


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We thank the field staff in Starr County for their careful collection of these data and are especially grateful to the residents of Starr County who graciously participated in the study.


This work was supported in part by grants HL092585 and HL102830 from the National Institutes of Health.

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Correspondence to David Aguilar.

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Singh, M., Hanis, C.L., Redline, S. et al. Sleep apnea and galectin-3: possible sex-specific relationship. Sleep Breath 23, 1107–1114 (2019).

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  • Sleep apnea
  • Galectin-3
  • High-sensitivity troponin