Association between serum neopterin, obesity and daytime sleepiness in patients with obstructive sleep apnea

Ursavaş, Ahmet; Karadağ, Mehmet; Oral, Arzu Yilmaztepe; Demirdöğen, Ezgi; Oral, Haluk Barbaros; Ege, Ercüment

doi:10.1016/j.rmed.2008.02.019

Cited by 23 publications

(22 citation statements)

References 28 publications

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“…These negative effects of OSA on myocardial structure and functions have been attributed to various factors, especially hypoxia and hypercapnia, which ensue during sleeping; increased negative intrathoracic pressure during the arousal phase and hemodynamic changes, which occur during sympathetic system activation; and oxidative stress, systemic inflammation, endothelial dysfunction, ox- ygen demand of the myocardium, and imbalances during presentation. 27,28 There were limitations to our study, including the use of the Epworth and Berlin scales rather than the AHI in the selection of the control individuals. However, in daily clinical practice, we use these methods to select appropriate subjects for the polysomnography test.…”

Section: Discussionmentioning

confidence: 99%

A Novel Method for Sensitive Determination of Subclinical Left-Ventricular Systolic Dysfunction in Subjects With Obstructive Sleep Apnea

et al. 2015

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BACKGROUND: This study was to evaluate the subclinical left-ventricular (LV) systolic dysfunction with 2-dimensional speckle-tracking echocardiography in subjects with obstructive sleep apnea (OSA) with normal left ventricular ejection fraction and without any confounding disease that can cause myocardial dysfunction. METHODS: Nineteen healthy individuals and 60 subjects with OSA were included in this study. According to the severity of disease, OSA subjects were examined in 3 groups: mild, moderate, and severe OSA. LV apical views (for longitudinal strain) and short-axis views (for circumferential strain) were acquired for evaluation. Three-layer longitudinal strain values and circumferential strain values were determined for each view, and averages of these were used in comparison with other groups. RESULTS: Three-layer longitudinal strain values of the subjects with OSA were lower than those of the healthy individuals, and these values were decreased along with the OSA severity. The difference was significant between severe OSA and all other groups. Three-layer circumferential strain values of the OSA subjects were lower than those of the healthy individuals, and the difference was significant between the control group and all other groups. The apnea hypopnea index was found to be correlated with the 3-layer longitudinal strain (r ‫؍‬ ؊0.74, P < .001; r ‫؍‬ ؊0.72, P < .001; r ‫؍‬ ؊0.69, P ‫؍‬ <.001). CONCLUSIONS: Three-layer longitudinal and circumferential LV systolic functions in OSA subjects with normal left ventricular ejection fraction are deteriorated in the subclinical stage. Two-dimensional speckle-tracking echocardiography can be used as an effective method in the determination of subclinical myocardial dysfunction in subjects with OSA. Key words: obstructive sleep apnea; speckle-tracking echocardiography; myocardial strain. [Respir Care 2016;61(3):366 -375.

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Section: Discussionmentioning

confidence: 99%

A Novel Method for Sensitive Determination of Subclinical Left-Ventricular Systolic Dysfunction in Subjects With Obstructive Sleep Apnea

et al. 2015

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“…In contrast, some studies indicate a positive association of BMI with neopterin [12,22,23], and inconsistencies might relate partly to the different study designs; one of the studies included mainly overweight and obese participants [22], whereas another presented only crude associations [23].…”

Section: Bmi and Physical Activitymentioning

confidence: 99%

“…KTR: kynurenine/tryptophan ratio; AA: anthranilic acid; HAA: 3-hydroxyanthranilic acid; HK: 3-hydroxykynurenine; KA: kynurenic acid; Kyn: kynurenine; Trp: tryptophan; XA: xanthurenic acid. 30 (27,32) 7 (8,5) 21 (19,23) 24 (21,27) 20 (18, 23) 21 (19, 24) 2 (0, 5) 22 (20,25) 18 (15, 22) 36 (32,41) 26 (22,30) 6 (2, 9) 25 (19,30) P for trend 16 (12,20) 11 (8,15) 17 (13,21) 13 (7,18) P for trend Moderate smoker…”

Section: Bmi and Physical Activitymentioning

confidence: 99%

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A community-based study on determinants of circulating markers of cellular immune activation and kynurenines: the Hordaland Health Study

Theofylaktopoulou

Midttun

Ulvik

et al. 2013

Clinical and Experimental Immunology

109

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SummaryCirculating neopterin and kynurenine/tryptophan ratio (KTR) increase during inflammation and serve as markers of cellular immune activation, but data are sparse on other determinants of these markers and metabolites of the kynurenine pathway. We measured neopterin, tryptophan, kynurenine, anthranilic acid, kynurenic acid, 3-hydroxykynurenine, 3-hydroxyanthranilic acid and xanthurenic acid in plasma in two age groups, 45-46 years (n = 3723) and 70-72 years (n = 3329). Differences across categories of the potential determinants, including age, gender, renal function, body mass index (BMI), smoking and physical activity, were tested by Mann-Whitney U-test and multiple linear regression including age group, gender, renal function and lifestyle factors. In this multivariate model, neopterin, KTR and most kynurenines were 20-30% higher in the older group, whereas tryptophan was 7% lower. Men had 6-19% higher concentrations of tryptophan and most kynurenines than women of the same age. Compared to the fourth age-specific estimated glomerular filtration rate (eGFR) quartile, the first quartile was associated with higher concentrations of neopterin (25%) and KTR (24%) and 18-36% higher concentrations of kynurenines, except 3-hydroxyanthranilic acid. Additionally, KTR, tryptophan and all kynurenines, except anthranilic acid, were 2-8% higher in overweight and 3-17% higher in obese, than in normal-weight individuals. Heavy smokers had 4-14% lower levels of tryptophan and most kynurenines than nonsmokers. Age and renal function were the strongest determinants of plasma neopterin, KTR and most kynurenines. These findings are relevant for the design and interpretation of studies investigating the role of plasma neopterin, KTR and kynurenines in chronic diseases.

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“…24 All the se re sults are con sis tent with re cent stu di es which sug ges ted OSA was a syste mic inf lam ma tory di se a se rat her than a lo cal ana to mi cal di sor der. 23,[25][26][27] Un li ke Ro u re et al who de mons tra ted sle ep time was long and sle ep ef fi ci ency was suf fi ci ent in OSA pa ti ents with EDS, we sho wed that the re was no dif fe ren ces for to tal sle ep ti me and sle ep ef fi ciency. 16 In li ne with the li te ra tu re, we sho wed no re la ti on bet we en dis tri bu ti on of sle ep pha ses and EDS.…”

Section: Discussionmentioning

confidence: 70%

Comparison of Polysomnography Variables in Obstructive Sleep Apnea Patients with or without Excessive Daytime Sleepiness

Gülbay¹,

Acican²,

Ciftci³

et al. 2014

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T OOb b j je ec c t ti i v ve e: : Excessive daytime sleepiness (EDS) is a common symptom in patients with obstructive sleep apnea (OSA), and the reason for this could not be fully elucidated. The aim of this study was to compare polysomnographic and demographic features of patients with OSA with or without EDS according to Epworth Sleepiness Scale (ESS). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A total of 82 adult patients who were diagnosed with OSA with polysomnography were retrospectively divided into 2 groups in terms of having EDS (ESS>10) or not (ESS≤10) according to ESS score. R Re es su ul lt ts s: : Forty six patients had an ESS score >10. Patients with OSA suffering from sleepiness were younger (p=0.010), more obese (p=0.039), had higher arousal index (p=0.051) and apnea hypopnea index (AHI) (p=0.036) on polysomnography. There was no gender difference between two groups (p=0.423). Polysomnographic findings revealed that there were no differences in total sleep time, sleep efficiency or overall distribution of sleep stages (N1,N2, N3, REM), or nocturnal mean and minimum saturation (p=0. 516, p=0.790, p=0.674, p=0.852, p=0.677, p=0.137, p=0.286, p=0.353, respectively). On multivariate regression analysis, arousal index, total AHI, and age were effective in determination of ESS score (p<0.001). C Co on nc cl lu us si io on n: : OSA patients with EDS were younger and more obese when compared to OSA patients with no EDS. No single factor was effective for detection of EDS with ESS score. Rather, factors such as severity of OSA, arousal index, and age were collectively decisive.K Ke ey y W Wo or rd ds s: : Sle ep ap ne a, obs truc ti ve; poly som nog raphy Ö ÖZ ZE ET T A Am ma aç ç: : Gün düz uy ku lu luk, obs trük tif uy ku ap ne li (OSA) has ta lar da sık gö rü len, an cak ne deni tam ola rak ay dın la tı la ma mış bir semp tom dur. Ça lış ma da Ep worth uy ku luk luk ska la sı (ESS) so nucu na gö re aşı rı uy ku lu lu ğu olan ve ol ma yan OSA' lı has ta la rın po li som nog ra fik ve de mog ra fik özel lik le ri nin kar şı laş tı rıl ma sı amaç lan dı. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Po li som nog ra fi ile OSA ta nı sı konmuş 82 [Ap ne hi pop ne in dek si (AHİ)>15/sa] eriş kin has ta (28 ka dın/54 er kek), ESS so nu cu na gö re gün düz aşı rı uy ku lu lu ğu (GA U) olan (ESS>10) ve ol ma yan (ESS≤10) şek lin de 2 grup ta ret ros pek tif ola rak in ce len di. B Bu ul l g gu u l la ar r: : Has ta lar dan 46'sın da ESS>10 idi. Gün düz uy ku lu lu ğu olan OSA' lı has talar da ha genç (p=0,010) ve obez di (0,039). Bu gru bun po li som nog ra fi le rin de aro u sal in dek si (p=0,051) ve ap ne hi pop ne in dek si (AHİ) da ha yük sek ti (p=0,036). İki grup ara sın da cin si yet fark lı lı ğı gö rül -me di (p=0,423). Po li som nog ra fi le rin de to tal uy ku sü re si, uy ku et kin li ği ya da uy ku ev re le ri nin da -ğı lı mı (N1,N2,N3,REM), nok tur nal or ta la ma sa tu ras yon ve en dü şük sa tu ras yon de ğer le ri açı sın dan, iki grup ara...

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Association between serum neopterin, obesity and daytime sleepiness in patients with obstructive sleep apnea

Abstract: We suggest that serum NP levels correlate with BMI. There was a significant relationship between serum NP levels and excessive daytime sleepiness in OSA patients.

Cited by 23 publications

References 28 publications

A Novel Method for Sensitive Determination of Subclinical Left-Ventricular Systolic Dysfunction in Subjects With Obstructive Sleep Apnea

A Novel Method for Sensitive Determination of Subclinical Left-Ventricular Systolic Dysfunction in Subjects With Obstructive Sleep Apnea

A community-based study on determinants of circulating markers of cellular immune activation and kynurenines: the Hordaland Health Study

Comparison of Polysomnography Variables in Obstructive Sleep Apnea Patients with or without Excessive Daytime Sleepiness

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