Background: Lipid metabolism is well-recognized as an important risk factor for obstructive sleep apnea (OSA), however, few studies have investigated their relationship comprehensively.The aim of our study was to clarify the associations by a large cross-sectional study.Methods: A total of 2983 participantswho tested by polysomnography (PSG)were suitable for this study.Serum lipid levels [i.e.total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-I (apoA-l), apolipoprotein B (apoB), apolipoprotein E (apoE), Lipoprotein(a) (Lp(a))] and anthropometric parameters [i.e.Waist circumference (WC), hip circumference (HC), neck circumference (NC),body mass index (BMI)] were measuredin these subjects.Binary logistic regression analysis was used to determine the independent risk of a single serum lipidfor OSA.Results: Of these included subjects, there were 561 non-OSA, 505 moderate, 478 mild, and 1439 severe patients, respectively.Patients in moderate and severe OSA groups were older, moreobese, and with higher serum lipid levels thanmild and non-OSAgroups (P < 0.001).Of these lipids, only TC, LDL-C, and apoB were independent risk factors for OSA with an OR of 1.262 (95% CI 1.109-1.438), 1.432 (95% Cl 1.233-1.664), and 5.582 (95% CI 2.643-11.787), respectively.Low-density lipoprotein cholesterol (LDL-C) was an independent lipid risk factor for OSAin the multistage analysis strategies.Conclusions: Of the lipid profile, only TC, LDL-C, and apoB were independent risk factors for OSA.Predominantly, the LDL-C was the independent risk factor after correcting other non-lipid confounding factors.