Circadian Variability of Fibrinolytic Markers and Endothelial Function in Patients with Obstructive Sleep Apnea

Bagai, Kanika; Muldowney, James A.S.; Song, Yanna; Wang, Lily; Bagai, Jayant; Artibee, Kay; Vaughan, Douglas E.; Malow, Beth A.

doi:10.5665/sleep.3414

Cited by 33 publications

(29 citation statements)

References 49 publications

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“…However, the concomitant elevation of PAI-1 and the interaction between plasminogen activators and PAI-1 leads to the formation of an enzyme-inhibitor complex, which inhibits plasminogen activation activity. 11 Many authors suggest a protective role of TGF-␤ on the cardiovascular system because low levels of this molecule are related to coronary artery disease with a poor prognosis. 22,29,30 TGF-␤ has been shown to induce PAI-1 synthesis in several cell systems.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 In recent years, coagulation in OSAS has received some attention, and different studies have focused on the fibrinolytic activity and the role of the plasminogen system in subjects with sleep apnea. [11][12][13][14][15] There are 2 forms of plasminogen activators: tissue-type (tPA) and urokinase-type (uPA). Both are serine proteases that convert plasminogen to the active enzyme plasmin.…”

Section: Introductionmentioning

confidence: 99%

“…However, contrasting results can be found in the literature concerning the relationship between PAI-1 and the severity of OSAS. 11,13,14,25 Our study was designed to assess the presence of a hypercoagulability state in OSAS subjects and in control subjects by comparing the levels of uPA, PAI-1, and TGF-␤. Additionally, we evaluated the effect of 1 month of CPAP treatment on plasminogen system activity.…”

Section: Introductionmentioning

confidence: 99%

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The Plasminogen System and Transforming Growth Factor-β in Subjects With Obstructive Sleep Apnea Syndrome: Effects of CPAP Treatment

Steffanina¹,

Proietti²,

Antonaglia

et al. 2015

Respir Care

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BACKGROUND: Obstructive sleep apnea syndrome (OSAS) has emerged as a risk factor for cardiovascular disease. A prothrombotic state may affect coagulation and participate in the atherosclerotic process in subjects with OSAS. These alterations in coagulation seem to involve the plasminogen activation system. We evaluated the imbalances of the plasminogen activation system related to OSAS, and we assessed the effects of CPAP on the plasminogen activation system. METHODS: Thirty-nine subjects were submitted to a home-based cardiorespiratory sleep study, and 14 healthy subjects (apnea-hypopnea index < 5) were used as controls. Serum levels of urokinase-type plasminogen activator (uPA), tissue-type plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), and active transforming growth factor-␤ (TGF-␤) were measured. These molecules were reassessed in only 17 of the subjects after 1 month of CPAP. RESULTS: PAI-1 and tPA were significantly higher in the subjects with OSAS compared with the controls, whereas TGF-␤ and uPA levels were lower. PAI-1 showed a significant positive correlation with the apnea-hypopnea index, percentage of time spent at O 2 saturation < 90%, and oxygen desaturation index, whereas TGF-␤ was inversely related to all 3 of these parameters. After the CPAP therapy, PAI-1 significantly decreased, whereas TGF-␤ showed a significant increase, although the values did not reach those of the controls. uPA and tPA did not show significant differences after the treatment. CONCLUSIONS: Our results suggest an imbalance of fibrinolysis related to OSAS and an improvement of the prothrombotic state after the CPAP treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Plasminogen System and Transforming Growth Factor-β in Subjects With Obstructive Sleep Apnea Syndrome: Effects of CPAP Treatment

Steffanina¹,

Proietti²,

Antonaglia

et al. 2015

Respir Care

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“…First, disturbed sleep may result in more nocturnal light exposure, which can adjust the circadian system . Second, OSA can augment the transcription of circadian proteins . Third, there is some evidence in humans and other animals to suggest that hypoxia impacts both the SCN and melatonin secretion .…”

Section: Normal Circadian Rhythm Synchronization and Bonementioning

confidence: 99%

“…(41) Second, OSA can augment the transcription of circadian proteins. (42) Third, there is some evidence in humans and other animals to suggest that hypoxia impacts both the SCN and melatonin secretion. (43) OSA has not been definitively shown to cause circadian disruption, but it has the potential to cause internal desynchrony and disruption of the day/night rhythm of BTMs, which could impact bone health.…”

Section: Normal Sleepmentioning

confidence: 99%

Obstructive Sleep Apnea and Metabolic Bone Disease: Insights Into the Relationship Between Bone and Sleep

Swanson

Shea

Stone

et al. 2015

Journal of Bone and Mineral Research

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Obstructive sleep apnea (OSA) and low bone mass are two prevalent conditions, particularly among older adults, a section of the U.S. population that is expected to grow dramatically over the coming years. OSA, the most common form of sleep disordered breathing, has been linked to multiple cardiovascular, metabolic, hormonal and inflammatory derangements and may have adverse effects on bone. However, little is known about how OSA (including the associated hypoxia and sleep loss) affects bone metabolism. In order to gain insight into the relationship between sleep and bone, we review the growing information on OSA and metabolic bone disease and discuss the pathophysiological mechanisms by which OSA may affect bone metabolism/architecture.

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The evaluation of serum brain‐derived neurotrophic factor and neurofilament light chain levels in patients with obstructive sleep apnea syndrome

Arslan

Şemsi

İriz

et al. 2021

Laryngoscope Investig Oto

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Objectives This study aimed to compare serum levels of brain‐derived neurotrophic factor (BDNF) and neurofilament light (NfL) chain in normal individuals and patients with mild and moderate‐severe obstructive sleep apnea syndrome (OSAS). Methods We enrolled 81 subjects referred to Otorhinolaryngology (Ear‐Nose‐Throat), Gazi University Faculty of Medicine, between 2017 and 2019. Based on the severity of OSAS, patients were divided into three groups: group 1 with mild OSAS (apnea‐hypopnea index [AHI] 5‐15; n = 26), group 2 with moderate‐severe OSAS (AHI > 15; n = 32), and group 3 with normal individuals (AHI scores < 5; n = 23). Results Serum NfL and BDNF levels were evaluated together with the clinical data for all subjects. Significant differences were seen in the oxygen desaturation index (ODI), apnea index, hypopnea index, sleep efficiency, and NfL levels (P < .05) between the three groups. In the moderate‐severe group, NfL levels showed a significant positive correlation with apnea index (P < .05, r = .389), hypopnea index (P < .05, r = .455), and ODI (P = .04; r = .362). Conclusions Our findings clarify the pathophysiology of OSAS in cases of repetitive hypoxia and chronic neuronal damage. Based on our results, we recommend that in addition to BDNF, NfL should also be evaluated in different and larger patient cohorts.

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Circadian Variability of Fibrinolytic Markers and Endothelial Function in Patients with Obstructive Sleep Apnea

Cited by 33 publications

References 49 publications

The Plasminogen System and Transforming Growth Factor-β in Subjects With Obstructive Sleep Apnea Syndrome: Effects of CPAP Treatment

The Plasminogen System and Transforming Growth Factor-β in Subjects With Obstructive Sleep Apnea Syndrome: Effects of CPAP Treatment

Obstructive Sleep Apnea and Metabolic Bone Disease: Insights Into the Relationship Between Bone and Sleep

The evaluation of serum brain‐derived neurotrophic factor and neurofilament light chain levels in patients with obstructive sleep apnea syndrome

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