Effect of CPAP on New Endothelial Dysfunction Marker, Endocan, in People With Obstructive Sleep Apnea

Abstract

Obstructive sleep apnea (OSA) is associated with increased cardiovascular (CV) morbidity and mortality. Endocan is a surrogate endothelial dysfunction marker that may be associated with CV risk factors. In this study, we tested whether serum endocan is a biomarker for OSA. Serum endocan levels were measured at baseline in 40 patients with OSA and 40 healthy controls and after 3 months of continuous positive airway pressure (CPAP) treatment in the patients with OSA. All participants were evaluated by full polysomnography. Flow-mediated dilatation (FMD) and carotid intima media thickness (cIMT) were measured in all participants. Endocan levels were significantly higher in patients with OSA than in healthy controls. After adjusting confounders, endocan was a good predictor of OSA. Endocan levels correlated with OSA severity (measured by the apnea–hypopnea index [AHI]). After 3 months of CPAP treatment, endocan levels significantly decreased. Endocan levels were significantly and independently correlated with cIMT and FMD after multiple adjustments. The cIMT and FMD also had significant and independent correlation with AHI. Endocan might be a useful marker for the predisposition of patients with OSA to premature vascular disease.

Endocan and the respiratory system: a review

“…Based on the association of obstructive sleep apnea (OSA) and endothelial dysfunction, endocan was also very recently investigated in a prospective study by Altintas et al74 The effect of the condition on the molecule’s levels was assessed in moderate-to-severe OSA patients, at baseline and following 3 months of continuous positive airway pressure treatment. According to the results, not only was endocan able to distinguish patients with OSA from individuals with suspected, though not confirmed, diagnosis but also further correlated with the severity of the condition, measured by the apnea-hypopnea index and the therapeutic response.…”

Endocan: A novel inflammatory indicator in cardiovascular disease?

“…Also, were inversely correlated with eGFR and this value influenced, independently of traditional and non-traditional risk factors, all-cause mortality and CVD events in 251 CKD patients. Multiple linear regression with serum endocan as the dependent variable showed that endocan levels had a significant and independent correlation with cIMT and FMD in patients with OSA [35]. …”

Serum Thiol/Disulfide Homeostasis and Endocan Levels in Patients Who Underwent Diagnostic Exercise Electrocardiography Test

“…Kundi et al demonstrated that endocan levels were significantly correlated with Syntax score and high-sensitive C-reactive protein (30) . In another study, endocan levels were found to be correlated with carotid intima media thickness and flow mediated dilation in obstructive sleep apnea patients (31) . All these studies suggest and support the possible association of endocan with inflammation and atherogenesis, but our findings are different.…”