Effects of Nasal Continuous Positive Airway Pressure Treatment on Oxidative Stress and Adiponectin Levels in Obese Patients with Obstructive Sleep Apnea

Abstract

Background: Obesity and obstructive sleep apnea (OSA) are both associated with the prevalence of major cardiovascular illnesses and certain common factors they are considered responsible for, such as stress oxidative increase, sympathetic tonus and resistance to insulin. Objective: The aim of the present study was to compare the effect of continuous positive airway pressure (CPAP) on oxidative stress and adiponectin levels in obese patients with and without OSA. Methods: Twenty-nine obese patients were categorized into 3 groups: group 1: 10 individuals without OSA (apnea-hypopnea index, AHI ≤5) who did not have OSA diagnosed at polysomnography; group 2: 10 patients with moderate to severe OSA (AHI ≧20) who did not use CPAP; group 3: 9 patients with moderate to severe OSA (AHI ≧20) who used CPAP. Results: Group 3 showed significant differences before and after the use of CPAP, in the variables of diminished production of superoxide, and increased nitrite and nitrate synthesis and adiponectin levels. Positive correlations were seen between the AHI and the superoxide production, between the nitrite and nitrate levels and the adiponectin levels, between superoxide production and the HOMA-IR, and between AHI and the HOMA-IR. Negative correlations were found between AHI and the nitrite and nitrate levels, between the superoxide production and that of nitric oxide, between the superoxide production and the adiponectin levels, between AHI and the adiponectin levels, and between the nitrite and nitrate levels and the HOMA-IR. Conclusions: This study demonstrates that the use of CPAP can reverse the increased superoxide production, the diminished serum nitrite, nitrate and plasma adiponectin levels, and the metabolic changes existing in obese patients with OSA.

Xanthine Oxidase Inhibition Attenuates Endothelial Dysfunction Caused by Chronic Intermittent Hypoxia in Rats

“…We would like to emphasize that previous human studies have used systemic markers to demonstrate increased oxidative stress in patients with OSA, diabetes and heart failure, and that these studies report beneficial effects of xanthine oxidase inhibition on systemic markers [34,49,57,58]. It is possible, however, that comorbid conditions such as obesity and increased insulin resistance [59,60] may have contributed to an oxidative stress ‘burden’ in those human subjects that was heightened relative to that experienced by our rats.…”

Obstructive sleep apnea and pregnancy: the effect on perinatal outcomes

“…82 Studies investigating the effect of good compliance with CPAP on leptin, 83,85 and adiponectin levels are also inconsistent. 84,86,87 Taken collectively, the main benefits of CPAP are the reduction of sleep disturbance and daytime symptoms, as well a reduction in short-term blood pressure among those with or without hypertension. These changes are accompanied by a concomitant reduction in sympathetic, hypothalamic-pituitary-adrenal and inflammatory activity with compliant use of CPAP.…”

Obstructive Sleep Apnoea Syndrome as a Systemic Low-Grade Inflammatory Disorder

“…Decreased adiponectin may result from increased sympathetic activity (Delporte et al, 2002), and higher levels of cytokines such as IL-6 and TNF (Fasshauer et al, 2003). In fact, there are conflicting reports as to whether CPAP treatment of OSAS effectively normalizes adiponectin levels (de Lima et al, 2010).…”