Influence of obstructive sleep apnea on serum butyrylcholinesterase activity and ischemia-modified albumin levels

Abstract

OBJECTIVE:To investigate the effect of obstructive sleep apnea and continuous positive airway pressure treatment on serum butyrylcholinesterase activity and ischemia-modified albumin levels.METHODS:Thirty-two patients with obstructive sleep apnea and 30 age- and sex-matched controls were enrolled and underwent a diagnostic polysomnogram. The serum butyrylcholinesterase activity, ischemia-modified albumin levels, metabolic parameters, and polysomnography scores were detected and evaluated. Nine patients were studied before and after treatment with continuous positive airway pressure.RESULTS:The serum ischemia-modified albumin levels were significantly higher and the butyrylcholinesterase activity was significantly lower in patients with obstructive sleep apnea than in the controls (p<0.001). The continuous positive airway pressure treatment decreased the modified albumin levels and elevated the buthrylcholinesterase activity (p = 0.019 and p = 0.023, respectively). The modified albumin levels were positively correlated with the apnea-hypopnea index (r = 0.462, p = 0.008) at baseline. Elevated ischemia-modified albumin levels can be more accurate than butyrylcholinesterase activity at reflecting the presence of obstructive sleep apnea. Receiver operating characteristic curves revealed a significant difference between the areas under the curve 0.916 for ischemia-modified albumin and 0.777 for butyrylcholinesterase (z = 2.154, p = 0.031).CONCLUSION:The elevated ischemia-modified albumin level was significantly associated with obstructive sleep apnea and was more sensitive than butyrylcholinesterase activity in reflecting obstructive sleep apnea. The continuous positive airway pressure treatment helped to ameliorate the imbalance.

Assessment of the role of serum ischemia-modified albumin in obstructive sleep apnea in comparison with interleukin-6

“…However, its possible role in OSA had not been clearly demonstrated yet. The number of studies focusing on this issue in the literature is limited [10,11,[26][27][28][29]. Yang et al [10] demonstrated a positive correlation between IMA levels and the OSA severity.…”

“…Considering the fact that the overproduction of ROS in obesity may modify the N-terminal region of the human serum albumin, which plays a vital role in the efficient antioxidant defense of the organism, protein oxidation products such as ischemia-modified albumin (IMA) may be a potential biomarker for OSA severity in association with obesity [9]. Although the potential role of serum IMA is well established in many clinical disorders, there is limited and contradictory information about the role of IMA in OSA [10,11]. We designed this prospective study to evaluate the potential role of IMA in comparison with interleukin-6 (IL-6) in OSA patients.…”

Increased Asymmetric Dimethylarginine and Ischemia-Modified Albumin Levels in Obstructive Sleep Apnea

“…26 Increased levels of ischemia-modified albumin may serve as a nonspecific risk marker for evaluation of the oxidative stress status and atherosclerotic burden. 13,27,28 Increased production of free radicals and pro-inflammatory cytokines in OSA are sources of the oxidative damage at the cellular and subcellular levels. 18 Yang et al 13 suggested that increased levels of ischemia-modified albumin in subjects with OSA may result from increased oxidative stress.…”

“…13,27,28 Increased production of free radicals and pro-inflammatory cytokines in OSA are sources of the oxidative damage at the cellular and subcellular levels. 18 Yang et al 13 suggested that increased levels of ischemia-modified albumin in subjects with OSA may result from increased oxidative stress. Ischemia-modified albumin is produced in response to ischemic stresses, such as hypoxia and acidosis.…”

“…Impairment of endothelium-dependent vasodilatation had been reflected as changes in levels of nitric oxide and asymmetric dimethylarginine in OSA. 8,12 Similarly, one study 13 implied that serum ischemia-modified albumin, an indicator of oxidative stress and inflammation, may serve as a biomarker in OSA. Our hypothesis was that these levels would be elevated.…”