Building Evidence Implicating Novel Cardiovascular Biomarkers in Obstructive Sleep Apnea

Mehra, Reena

doi:10.5664/jcsm.6476

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…). A recent editorial by Mehra also highlights the importance of identifying cost‐effective, precise biomarkers for cardiometabolic risk that allow clinicians to potentially identify OSA patients who would be most likely to benefit from therapy (Mehra ). CRP is perhaps the most widely studied and consistently elevated biomarker in children, adolescents, and adults with OSA, even independent of obesity and other confounders (Archontogeorgis et al.…”

Section: Discussionmentioning

confidence: 99%

“…A joint "biomarker workshop" on sleep health biomarkers sponsored by the National Heart Lung and Blood Institute, National Institute on Aging, and the Sleep Research Society advised that the sleep field is in need of a "unique OSA biomarker signature that is context-relevant, simple and easy to use" which will help clinicians determine a patient's long-term prognosis and treatment response (Mullington et al 2016). A recent editorial by Mehra also highlights the importance of identifying costeffective, precise biomarkers for cardiometabolic risk that allow clinicians to potentially identify OSA patients who would be most likely to benefit from therapy (Mehra 2017). CRP is perhaps the most widely studied and consistently elevated biomarker in children, adolescents, and adults with OSA, even independent of obesity and other confounders (Archontogeorgis et al 2014).…”

Section: Discussionmentioning

confidence: 99%

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C-reactive protein improves the ability to detect cardiometabolic risk in mild-to-moderate obstructive sleep apnea

Gaines

Kong

et al. 2017

Physiol Rep

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Obstructive sleep apnea (OSA), particularly in the mild‐to‐moderate range, affects up to 40% of the adult general population. While it is clear that treatment should be pursued in severe cases of OSA, when and how to best treat OSA in the mild‐to‐moderate range remains complicated, despite its high prevalence. The aim of this study was to compare the relative utility of apnea/hypopnea index (AHI) versus a biomarker of inflammation, C‐reactive protein (CRP), in identifying the presence and severity of hypertension and hyperglycemia. Middle‐aged (n = 60) adults with mild‐to‐moderate OSA (AHI between 5 and 29 events per hour) underwent 8‐h polysomnography, a physical examination including measures of blood pressure and body mass index, and a fasting morning blood draw for glucose and CRP. CRP levels were associated with greater odds for having hypertension and hyperglycemia compared to AHI. Receiver‐operating characteristics (ROC) curves revealed that adding CRP to standard clinical factors (age, sex, and BMI) yielded moderately good to strong risk models for the disorders (AUC = 0.721 and AUC = 0.813, respectively). These preliminary findings suggest that including a measure of CRP improves the ability for clinicians to detect cases of mild‐to‐moderate OSA with true cardiometabolic risk, with implications in improving prognosis and treatment within this clinically gray area.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

C-reactive protein improves the ability to detect cardiometabolic risk in mild-to-moderate obstructive sleep apnea

Gaines

Kong

et al. 2017

Physiol Rep

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“…A recent joint biomarker workshop sponsored by the National Heart Lung and Blood Institute, National Institute on Aging, and the Sleep Research Society advised that the sleep field lacks a “unique biomarker signature that is context -relevant, simple and easy to use” that can help clinicians determine a patient’s long-term prognosis [104]. Furthermore, a recent editorial highlights the importance of identifying precise, cost-effective biomarkers for cardiometabolic risk that allow clinicians to identify OSA patients who are most likely to benefit from therapy [105]. We have previously demonstrated that inflammation (specifically, CRP) is elevated in a dose-response manner across OSA patients with hypertension, OSA patients without hypertension, and controls, suggesting that inflammation may be a clinically useful marker of OSA severity and comorbid cardiovascular problems [106].…”

Section: In Search Of a Clinically-useful Biomarker Of Cardiometabolimentioning

confidence: 99%

Obstructive sleep apnea and the metabolic syndrome: The road to clinically-meaningful phenotyping, improved prognosis, and personalized treatment

Gaines

Vgontzas

Fernández-Mendoza

et al. 2018

Sleep Medicine Reviews

173

128

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Summary Obstructive sleep apnea (OSA) is an increasingly prevalent sleep disorder characterized by upper airway obstruction during sleep, resulting in breathing pauses, intermittent hypoxia, and fragmented sleep. In parallel, the constellation of adverse health outcomes associated with prolonged obesity, such as insulin resistance, elevated blood pressure, triglycerides, and reduced high-density lipoprotein cholesterol – termed metabolic syndrome –raises the risk of cardiovascular morbidity and mortality, type 2 diabetes, and all-cause mortality. Affecting 35–40% of U.S. adults, risk factors for metabolic syndrome, including obesity, middle age, sedentary behavior, and genetics, share considerable overlap with those for OSA. Thus, it has been difficult to disentangle cause, effect, and whether certain treatments, such as CPAP, can improve these outcomes. In this paper, we provide an update to our 2005 review which explored the association between OSA and metabolic syndrome, highlighting visceral obesity as the common etiological factor of both conditions. This update includes (a) recent data on physiological and biochemical mechanisms, (b) new data in nonobese men and women as well as children and adolescents, (c) insight from the latest treatment studies, (d) the role of aging in understanding clinically-meaningful phenotypes of the disorder, and (e) the potential diagnostic/prognostic utility of biomarkers in identifying OSA patients with the strongest cardiometabolic risk.

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“…More research in this direction is required to either confirm or reject change of TRP metabolites levels as potential biomarkers in OSA-related diseases [99]. General is the need to go ahead with the investigation on biologically meaningful biomarkers that are cost-effective, valid, and precise to accurately predict cardiovascular risk in OSA to inform personalized medicine strategies and potentially identify those most likely to benefit from therapy, thereby informing future clinical trials [100].…”

Section: Search For Osa Biomarkersmentioning

confidence: 99%

Analytical lights and shadows in metabolomics research on obstructive sleep apnea

LS¹,

Jurado-Gámez²,

Castro³

2020

J Stem Cell Res Med

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The gold-standard diagnostic test for OSA is labor-and timeintensive in laboratory polysomnography (PSG) [8,9]. Nocturnal continuous positive airway pressure (CPAP) therapy seems to be the most effective treatment for OSA. A CPAP device consists of a unit that generates airflow, which is directed to the airway via a mask and prevents upper airway collapse; thus, it is presumed to reverse the pathophysiological consequences of OSA. Nevertheless, the association of OSA to many chronic diseases such as hypertension [10], myocardial

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Building Evidence Implicating Novel Cardiovascular Biomarkers in Obstructive Sleep Apnea

Cited by 3 publications

References 8 publications

C-reactive protein improves the ability to detect cardiometabolic risk in mild-to-moderate obstructive sleep apnea

C-reactive protein improves the ability to detect cardiometabolic risk in mild-to-moderate obstructive sleep apnea

Obstructive sleep apnea and the metabolic syndrome: The road to clinically-meaningful phenotyping, improved prognosis, and personalized treatment

Analytical lights and shadows in metabolomics research on obstructive sleep apnea

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