Effect of Continuous Positive Airway Pressure on Soluble CD40 Ligand in Patients With Obstructive Sleep Apnea Syndrome

Kobayashi, Kazuyuki; Nishimura, Yoshihiro; Shimada, Temiko; Yoshimura, Sho; Funada, Yasuhiro; Satouchi, Miyako; Yokoyama, Mitsuhiro

doi:10.1378/chest.129.3.632

Cited by 44 publications

(34 citation statements)

References 28 publications

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“…Meta-regression also showed the same modest trend of significant influence of age, BMI, and AHI. Many studies have found that patients with OSAS have higher level of TNF-α, 20,22,23,79,[85][86][87] and the level of TNF-α was correlated to OSA severity and nocturnal hypoxemia. 22,23,80,85 On the other hand, Fornadi et al did not find any significant difference in TNF-α level in 100 randomly selected kidney transplant patients, and there was no significant correlation with AHI.…”

Section: 83mentioning

confidence: 99%

Serum Inflammatory Markers in Obstructive Sleep Apnea: A Meta-Analysis

Nadeem

Molnár

Madbouly

et al. 2013

Journal of Clinical Sleep Medicine

364

308

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Section: 83mentioning

confidence: 99%

Serum Inflammatory Markers in Obstructive Sleep Apnea: A Meta-Analysis

Nadeem

Molnár

Madbouly

et al. 2013

Journal of Clinical Sleep Medicine

364

308

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“…The critical pressure was determined by an automatic CPAP device (REM star Auto M series with C-Flex, Respironics). The recording methods were described in detail previously (13,34).…”

Section: Human Studiesmentioning

confidence: 99%

Nocturnal reduction in circulating adiponectin concentrations related to hypoxic stress in severe obstructive sleep apnea-hypopnea syndrome

Nakagawa¹,

Kishida²,

Kihara³

et al. 2008

American Journal of Physiology-Endocrinology and Metabolism

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Previous reports demonstrated that adiponectin has antiatherosclerotic properties. Obstructive sleep apnea-hypopnea syndrome (OSAHS) is reported to exacerbate atherosclerotic diseases. We investigated nocturnal alternation of serum adiponectin levels before sleep and after wake-up in OSAHS patients and the effect of sustained hypoxia on adiponectin in vivo and in vitro. We measured serum adiponectin concentrations in 75 OSAHS patients and 18 control subjects before sleep and after wake-up and examined the effect of one-night nasal continuous positive airway pressure (nCPAP) on adiponectin in 24 severe OSAHS patients. We investigated the effects of hypoxia on adiponectin in mice and cultured adipocytes with a sustained hypoxia model. Circulating adiponectin levels before sleep and after wake-up were lower in severe OSAHS patients than in control subjects [before sleep: 5.9 Ϯ 2.9 vs. 8.8 Ϯ 5.6 g/ml (P Ͻ 0.05); after wake-up: 5.2 Ϯ 2.6 vs. 8.5 Ϯ 5.5 g/ml (P Ͻ 0.01), respectively; means Ϯ SD]. Serum adiponectin levels diminished significantly during sleep in severe OSAHS patients (P Ͻ 0.0001), but one-night nCPAP improved the drop in serum adiponectin levels [Ϫ18.4 Ϯ 13.4% vs. Ϫ10.4 Ϯ 12.4% (P Ͻ 0.05)]. In C57BL/6J mice and 3T3-L1 adipocytes, hypoxic exposure decreased adiponectin concentrations by inhibiting adiponectin regulatory mechanisms at secretion and transcriptional levels. The present study demonstrates nocturnal reduction in circulating adiponectin levels in severe OSAHS. Our experimental studies showed that hypoxic stress induced adiponectin dysregulation at transcriptional and posttranscriptional levels. Hypoxic stress is, at least partly, responsible for the reduction of serum adiponectin in severe OSAHS. Nocturnal reduction in adiponectin in severe OSAHS may be an important risk for cardiovascular events or other OSAHSrelated diseases during sleep. nasal continuous positive airway pressure RECENT STUDIES HAVE DEMONSTRATED that adipose tissue is not only a passive reservoir for energy storage but also produces and secretes a variety of bioactive molecules called adipocytokines, including adiponectin (1a, 20), tumor necrosis factor-␣, leptin, and plasminogen activator inhibitor type 1 (PAI-1) (36). Dysregulated production of adipocytokines is associated with the pathophysiology of obesity-related diseases (1a, 9, 27). The biological functions of adiponectin, which we identified as an adipocytokine in the human adipose cDNA library (20), include improvement of glucose (21) and lipid metabolism (26), prevention of inflammation (31) and atherosclerosis (24), and cardiovascular protection (14,30,38). Serum adiponectin levels are low in visceral obesity (1a), insulin resistance (10), type 2 diabetes (9), and cardiovascular diseases (29). Previous studies demonstrated the possible association between visceral obesity and obstructive sleep apnea-hypopnea syndrome (OSAHS) (39,40). More recent studies reported that obese subjects with OSAHS had hypoadiponectinemia (36,46).In patients with OSAHS, repetitive noctu...

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“…1,2 Further support of this concept is derived from studies linking SDB to atherosclerotic pathways. [3][4][5][6] These studies provide insight into the mechanisms of vascular injury secondary to SDB. Although the impact of duration of this disorder on the development of risk factors for cardiovascular disease is difficult to estimate, morbidity secondary to SDB seems to manifest gradually, often taking decades.…”

mentioning

confidence: 97%

Activity-Adjusted 24-Hour Ambulatory Blood Pressure and Cardiac Remodeling in Children with Sleep Disordered Breathing

et al. 2008

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Abstract-Questions remain as to whether pediatric sleep disordered breathing increases the risk for elevated blood pressure and blood pressure-dependent cardiac remodeling. We tested the hypothesis that activity-adjusted morning blood pressure surge, blood pressure load, and diurnal and nocturnal blood pressure are significantly higher in children with sleep disordered breathing than in healthy controls and that these blood pressure parameters relate to left ventricular remodeling. 24-hour ambulatory blood pressure parameters were compared between groups. The associations between blood pressure and left ventricular relative wall thickness and mass were measured. 140 children met the inclusion criteria. In children with apnea hypopnea index Ͻ5 per hour, a significant difference from controls was the morning blood surge. Significant increases in blood pressure surge, blood pressure load, and in 24-hour ambulatory blood pressure were evident in those whom the apnea hypopnea index exceeded 5 per hour. Sleep disordered breathing and body mass index had similar effect on blood pressure parameters except for nocturnal diastolic blood pressure, where sleep disordered breathing had a significantly greater effect than body mass index. Diurnal and nocturnal systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure predicted the changes in left ventricular relative wall thickness. Therefore, sleep disordered breathing in children who are otherwise healthy is independently associated with an increase in morning blood pressure surge, blood pressure load, and 24-hour ambulatory blood pressure. The association between left ventricular remodeling and 24-hour blood pressure highlights the role of sleep disordered breathing in increasing cardiovascular morbidity. Key Words: sleep apnea Ⅲ children Ⅲ ambulatory blood pressure Ⅲ blood pressure surge Ⅲ blood pressure load Ⅲ cardiac remodeling Ⅲ hypertrophy T he association between sleep disordered breathing (SDB) and cardiovascular morbidity in adults has become an important consideration in the management of patients with SDB. Results from numerous cross-sectional and prospective studies of blood pressure (BP) control in adults support the concept that hypertension is an intermediate end point between SDB and cardiovascular disease. 1,2 Further support of this concept is derived from studies linking SDB to atherosclerotic pathways. [3][4][5][6] These studies provide insight into the mechanisms of vascular injury secondary to SDB. Although the impact of duration of this disorder on the development of risk factors for cardiovascular disease is difficult to estimate, morbidity secondary to SDB seems to manifest gradually, often taking decades. As such, with the exception of isolated cases of heart failure, children with SDB rarely show evidence of cardiovascular disease. Thus far, studies addressing whether children with SDB acquire risk factors for the early development of cardiovascular disease are inconclusive.Findings from several pediatric studies suggest ...

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Effect of Continuous Positive Airway Pressure on Soluble CD40 Ligand in Patients With Obstructive Sleep Apnea Syndrome

Cited by 44 publications

References 28 publications

Serum Inflammatory Markers in Obstructive Sleep Apnea: A Meta-Analysis

Serum Inflammatory Markers in Obstructive Sleep Apnea: A Meta-Analysis

Nocturnal reduction in circulating adiponectin concentrations related to hypoxic stress in severe obstructive sleep apnea-hypopnea syndrome

Activity-Adjusted 24-Hour Ambulatory Blood Pressure and Cardiac Remodeling in Children with Sleep Disordered Breathing

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