Correlation between pentraxin-3 and endothelial dysfunction in obstructive sleep apnea syndrome

Abstract

BACKGROUND AND AIM:Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for cardiovascular disease. Recent studies showed endothelial dysfunction and pentraxin-3 both of an early marker for development of cardiovascular disease. The aim of the study was to evaluate the relationship between severity of OSAS and endothelial dysfunction and inflammatory markers including pentraxin-3 and high-sensitivity C-reactive protein (hs-CRP).METHODS:This was a cross-sectional study in which patients who had undergone a polysomnographic study for diagnosis of OSAS were recruited. Included patients were grouped according to apnea-hypopnea index (AHI) as mild (AHI between 5 and 14.9) and moderate-severe OSAS (AHI ⩾ 15). Patients with AHI < 5 served as control group. Endothelial function was evaluated by flow-mediated dilatation (FMD). Serum pentraxin-3 and hs-CRP levels were measured.RESULTS:Eighty-three patients enrolled for the study. We found a significant increment in pentraxin-3 and hs-CRP levels and a significant decrement in FMD as the severity of OSAS increased. There was a negative correlation between FMD and AHI, pentraxin, and hs-CRP.CONCLUSION:OSAS patients have significantly elevated pentraxin-3 levels and endothelial dysfunction. Furthermore, both pentraxin-3 and endothelial dysfunction were independently associated with severity of OSAS defined by AHI.

Changes in inflammatory mediators as a result of intermittent hypoxia in obstructive sleep apnea syndrome

“…OSAS is a clinical condition characterized by recurrent upper airway obstruction during sleep and associated with increased systemic inflammatory markers. The association between inflammation and the presence of sleep‐disordered breathing has been shown in many studies . In the current study, we found that patients with OSAS have elevated plasma PTX‐3, IL‐33 and sST2 levels.…”

Endocan: a novel predictor of endothelial dysfunction in obstructive sleep apnea syndrome

“…Inflammation may be the explanation for such an association. In a recent study, we showed an independent strong association between inflammation, endothelial dysfunction and OSA . The last explanation may be the increase in vascular adhesion molecules.…”

“…New biomarkers showing OSA prognosis will be of value especially for future CV risk stratification. Various underlying mechanisms including oxidative stress, inflammation, reduced plasma levels of nitrite and nitrate, increased lipid peroxidation, sympathetic activation, insulin resistance and reduced antioxidant capacity are thought to be involved in OSA pathogenesis .…”

“…Endothelial dysfunction and vascular remodeling are also associated with OSA . Recently, a novel molecule ‘Endocan’ was found to be associated with entities such as cancer, hypertension, renal transplant rejection and chronic renal failure .…”

Does experimental paradoxical sleep deprivation (EPSD) is an appropriate model for evaluation of cardiovascular complications of obstructive sleep apnea?

“…Increase of sympathetic nervous system (SNS) activity, increase of vascular resistance, activation of the renin-angiotensin-aldosterone system, and increase of arterial stiffness following sleep loss and hypoxemia are some involving factors in this type of hypertension [25][26][27]. In addition, patients that suffer from OSA have some degrees of endothelial dysfunction [28] that may be another predisposing factor for hypertension. However, this effect cannot be attributed to the hyperactivity of hypothalamic-pituitary-adrenal (HPA) axis [24,29].…”