Cardiovascular Disease Risk in Obstructive Sleep apnea: An Update

Yacoub, Mena; Youssef, Irini; Salifu, Moro O.; McFarlane, Samy I.

doi:10.4172/2167-0277.1000283

Cited by 33 publications

(32 citation statements)

References 38 publications

(36 reference statements)

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“…This disease is associated with insulin resistance ( 2 ), obesity ( 3 ), and metabolic syndrome ( 4 ), and is a major risk factor for type II diabetes ( 5 ). OSAS is also associated with cardiovascular disease ( 6 ). One study found that the prevalence rate for moderate to severe OSAS was 23.4% in female individuals, 49.7% in male individuals, and 70% in individuals with obesity ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Serum and Plasma Interleukin-6 Levels in Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression

et al. 2020

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Obstructive sleep apnea syndrome (OSAS) is considered a low-grade chronic inflammatory disease. Interleukin-6 (IL-6) is one of the most significant inflammatory markers and an excellent proxy for the inflammatory/immune system. The present meta-analysis and meta-regression aimed at comparing plasma and serum levels of IL-6 between individuals (children and adults) with OSAS and healthy controls. Four databases, PubMed/Medline, Scopus, Cochrane Library, and Web of Science, were comprehensively searched to retrieve articles published up to December, 2019, with no further restrictions. RevMan 5.3 software was used to calculate the crude mean difference (MD) and 95% confidence interval (CI). The results of funnel plots and meta-regression were analyzed by the CMA 2.0 software. Sixty-three studies (57 with adults; six with children) were included in the present meta-analysis. For adults, 37 studies reported significantly higher serum IL-6 levels and 20 reported significantly higher plasma IL-6 levels for those with OSAS than for healthy controls [pooled MD of 2.89 pg/ml ( P < 0.00001) and pooled MD of 2.89 pg/ml ( P < 0.00001), respectively]. The pooled analysis of serum and plasma IL-6 levels in children with OSAS compared with controls revealed that only the MD of plasma IL-6 levels was significant (MD = 0.84 pg/ml, P = 0.004). Results of the meta-regression showed that greater age was associated with higher serum IL-6 levels. Egger's test revealed a publication bias across the studies for serum and plasma IL-6 levels ( P = 0.00044 and P = 0.01445, respectively). In summary, the meta-analysis and meta-regression confirmed that, compared to healthy controls, individuals with OSAS (children and adults) had higher serum/plasma IL-6 levels.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Serum and Plasma Interleukin-6 Levels in Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression

et al. 2020

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“…Obstructive sleep apnea syndrome (OSAS) is a disorder characterized by intermittent hypoxia during sleep followed by adipose tissue inflammation and has been shown to contribute to cardiovascular morbidity and mortality [ 1 , 2 ]. OSAS affects approximately 3% to 7% of adult men and 2% to 5% of adult women in the general population [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Interactions among Obstructive Sleep Apnea Syndrome Severity, Sex, and Obesity on Circulatory Inflammatory Biomarkers in Patients with Suspected Obstructive Sleep Apnea Syndrome: A Retrospective, Cross-Sectional Study

Chen

et al. 2020

IJERPH

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The interaction among obstructive sleep apnea syndrome (OSAS) severity, sex, and obesity on cardiovascular risk as determined by serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) remains unclear. Therefore, this study aimed to analyze individual associations between these three OSAS characteristics and three cardiovascular biomarkers and to determine whether the relationship was affected by other features in patients with suspected OSAS. For all participants (n = 100), OSAS severity and sex had an interaction effect on IL-6 level (p = 0.030). Specifically, the male patients (p = 0.005) with severe OSAS had higher IL-6 levels than those with normal to moderate OSAS, but this relationship was not significant in the female patients (p = 0.438). Moreover, in patients with normal to moderate OSAS (p = 0.004), but not in those with severe OSAS (p = 0.824), the female patients had higher IL-6 levels than the male patients. Both CRP (p = 0.001) and IL-6 (p = 0.000) levels were higher in the obese group than in the non-obese group independently of OSAS severity and sex. The three features had no effects on TNF-α level individually and interactively. Our findings suggest that circulatory inflammatory markers should be comprehensively evaluated in this population and that treatment and preventive therapies should be modified accordingly.

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“…Moreover, SAS has been related with a 5-fold increase in the risk for developing cardiovascular diseases (CVD), which could rise to 11-fold if not conveniently treated (Peker et al, 2002). In this way, SAS represents a well-known cause of secondary systemic and pulmonary hypertension, and a significant risk factor for coronary artery disease, cardiac arrhythmias, and heart failure (Yacoub et al, 2017; Tietjens et al, 2019). Analogously, some CVD such as heart failure, atrial fibrillation, or stroke may exert a negative effect in SAS, as a deficient blood conduction could lead to a dysregulation of PaCO 2 and hence trigger CSA episodes (Kasai et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Autonomic Dysfunction Increases Cardiovascular Risk in the Presence of Sleep Apnea

et al. 2019

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The high prevalence of sleep apnea syndrome (SAS) and its direct relationship with an augmented risk of cardiovascular disease (CVD) have raised SAS as a primary public health problem. For this reason, extensive research aiming to understand the interaction between both conditions has been conducted. The advances in non-invasive autonomic nervous system (ANS) monitoring through heart rate variability (HRV) analysis have revealed an increased sympathetic dominance in subjects suffering from SAS when compared with controls. Similarly, HRV analysis of subjects with CVD suggests altered autonomic activity. In this work, we investigated the altered autonomic control in subjects suffering from SAS and CVD simultaneously when compared with SAS patients, as well as the possibility that ANS assessment may be useful for the early stage identification of cardiovascular risk in subjects with SAS. The analysis was performed over 199 subjects from two independent datasets during night-time, and the effects of the physiological response following an apneic episode, sleep stages, and respiration on HRV were taken into account. Results, as measured by HRV, suggest a decreased sympathetic dominance in those subjects suffering from both conditions, as well as in subjects with SAS that will develop CVDs, which was reflected in a significantly reduced sympathovagal balance ( p < 0.05). In this way, ANS monitoring could contribute to improve screening and diagnosis, and eventually aid in the phenotyping of patients, as an altered response might have direct implications on cardiovascular health.

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Cardiovascular Disease Risk in Obstructive Sleep apnea: An Update

Cited by 33 publications

References 38 publications

Evaluation of Serum and Plasma Interleukin-6 Levels in Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression

Evaluation of Serum and Plasma Interleukin-6 Levels in Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression

Interactions among Obstructive Sleep Apnea Syndrome Severity, Sex, and Obesity on Circulatory Inflammatory Biomarkers in Patients with Suspected Obstructive Sleep Apnea Syndrome: A Retrospective, Cross-Sectional Study

Autonomic Dysfunction Increases Cardiovascular Risk in the Presence of Sleep Apnea

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