Effects of obstructive sleep apnea on serum brain-derived neurotrophic factor protein, cortisol, and lipid levels

Busarakumtragul, Panaree; Mekseepralard, Chantana; Sukhumsirichart, Wasana; Neruntarat, Chairat

doi:10.1007/s11325-010-0415-7

Cited by 29 publications

(32 citation statements)

References 62 publications

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“…One study compared OSA patients with and without excessive daytime sleepiness (EDS); the group without EDS (but not those with EDS) was significantly older than the control group (13). In the remaining two studies, subjects in the control group were significantly younger than subjects in the OSA group (16,18). Four studies utilized a control group with a similar BMI to the OSAgroup;in three of these studies a normal weight control group was also employed (9,14,15,17).…”

Section: Resultsmentioning

confidence: 96%

“…In relation to aims 1 and 2, the literature search identified: (1) seven studies on patients with OSA versus healthy controls fulfilling the inclusion criteria (9,13–18), (2) eight studies on patients with OSA who were treated with CPAP (9,10,13,15,19–22). Three studies fit into both categories (e.g., data was presented comparing OSA versus healthy controls followed by treatment of the OSA group with CPAP) (9,13,15).…”

Section: Resultsmentioning

confidence: 99%

“…As per the inclusion criteria, healthy controls each had an AHI of less than 5. In threestudies patients were diagnosed with OSA if AHI ≥ 5 (13,16,17) and in two studies patients were diagnosed with OSA if AHI ≥ 10 (15,18), and in two studies, patients were diagnosed with OSA if AHI ≥ 20 (9,14). The median AHI score within the OSA group was 50 and the range was 22.3 to 65.7.…”

Section: Resultsmentioning

confidence: 99%

“…Samples were overwhelmingly male with only one investigation reporting women in the OSA group(18). There was considerable variability in approaches to matching patients and controls.…”

Section: Resultsmentioning

confidence: 99%

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Is obstructive sleep apnea associated with cortisol levels? A systematic review of the research evidence

Tomfohr

Edwards

Dimsdale

2012

Sleep Medicine Reviews

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The pathophysiology of obstructive sleep apnea (OSA) has been associated with dysregulation of the hypothalamic pituitary adrenal (HPA) axis; however a relationship between OSA and altered cortisol levels has not been conclusively established. We conducted a systematic review using the PRISMA Guidelines based on comprehensive database searches for (1) studies of OSA patients compared to controls in whom cortisol was measured and (2) studies of OSA patients treated with continuous positive airway pressure (CPAP) in whom cortisol was measured pre and post treatment. Five electronic databases were searched along with the reference lists of retrieved studies. The primary outcomes were (1) differences in cortisol between OSA and control subjects and (2) differences in cortisol pre-post CPAP treatment. Sampling methodology, sample timing and exclusion criteria were evaluated. Fifteen studies met the inclusion criteria. Heterogeneity of studies precluded statistical pooling. One study identified differences in cortisol between OSA patients and controls. Two studies showed statistically significant differences in cortisol levels pre-post CPAP. The majority of studies were limited by assessment of cortisol at a single time point. The available studies do not provide clear evidence that OSA is associated with alterations in cortisol levels or that treatment with CPAP changes cortisol levels. Methodological concerns such as infrequent sampling, failure to match comparison groups on demographic factors known to impact cortisol levels (age, body mass index; BMI),and inconsistent control of variables known to influence HPA function may have limited the results.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Samples were overwhelmingly male with only one investigation reporting women in the OSA group(18). There was considerable variability in approaches to matching patients and controls.…”

Section: Resultsmentioning

confidence: 99%

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Is obstructive sleep apnea associated with cortisol levels? A systematic review of the research evidence

Tomfohr

Edwards

Dimsdale

2012

Sleep Medicine Reviews

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“…The associated hypoxaemia and the concomitant increase in arterial carbon dioxide tension are expected to result in sympathetic activation and catecholamine secretion, while the repeated arousals can cause activation of the hypothalamic-pituitary-adrenal (HPA) axis, thus increasing cortisol release [2]. However, and contrary to what was expected, most studies have reported no significant association [3][4][5][6][7][8] or decreased HPA axis activity [9], whereas only two studies reported increased HPA axis activity in sleep apnoea patients compared with controls [10,11]. A more recent study [12] found a significant association between apnoea severity and 24-h cortisol values; however, it was limited by the absence of a control group.…”

Section: Introductionmentioning

confidence: 93%

Sleep apnoea and the hypothalamic–pituitary–adrenal axis in men and women: effects of continuous positive airway pressure

et al. 2015

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Previous findings on the association of obstructive sleep apnoea (OSA) and the hypothalamic-pituitary-adrenal (HPA) axis are inconsistent, partly due to the confounding effect of obesity and infrequent sampling. Our goal was to examine whether in a relatively nonobese population, OSA is associated with elevated cortisol levels and to assess the effects of a 2-month placebo-controlled continuous positive airway pressure (sham-CPAP) use.72 subjects (35 middle-aged males and post-menopausal females with OSA, and 37 male and female controls) were studied in the sleep laboratory for four nights. 24-h blood sampling was performed every hour on the fourth day and night in the sleep laboratory at baseline, after sham-CPAP and after CPAP treatment.In both apnoeic men and women, OSA was associated with significantly higher 24-h cortisol levels compared with controls, whereas CPAP lowered cortisol levels significantly, close to those of controls.These results suggest that OSA in nonobese men and slightly obese women is associated with HPA axis activation, similar albeit stronger compared with obese individuals with sleep apnoea. Short-term CPAP use decreased cortisol levels significantly compared with baseline, indicating that CPAP may have a protective effect against comorbidities frequently associated with chronic activation of the HPA axis, e.g. hypertension.@ERSpublications OSA in nonobese men/slightly obese women is associated with HPA axis activation and CPAP lowers HPA axis activity http://ow.ly/Stn94

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Serum testosterone/cortisol ratio in people with obstructive sleep apnea

Mohammadi

Rezaei

Sharafkhaneh

et al. 2019

Clinical Laboratory Analysis

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Objectives Obstructive sleep apnea (OSA) is a major health problem that has been associated with endocrine dysfunction in the hypothalamic‐pituitary‐gonadal (HPG) and hypothalamic‐pituitary‐adrenal (HPA) axes. This study investigated cortisol, testosterone, and the testosterone/cortisol ratio in patients with OSA compared to normal sleepers. Methods Thirty‐nine OSA patients diagnosed by overnight polysomnography (PSG) were divided into three groups, including ten mild OSA patients, 16 patients with moderate OSA, and 13 patients with severe OSA according to the apnea‐hypopnea index (AHI). In addition, 13 normal sleepers with normal PSG findings were recruited as the control group. Serum levels of cortisol, testosterone, and sex hormone‐binding globulin (SHBG) were measured using enzyme‐linked immunosorbent assay (ELISA). Results There were no significant differences between the normal sleepers and the three subtypes of OSA in terms of total and free testosterone levels (P > .1). The results showed significantly higher levels of cortisol in the severe OSA group compared to the normal sleepers and the two other subtypes of OSA (P < .01). In addition, the testosterone/cortisol (T/C) ratio was significantly lower among the severe OSA compared to the moderate OSA patients (P = .01). A significant correlation was observed between minimal SpO2 and AHI (r=−0.69, P < .01), cortisol and AHI (r = .47, P < .01) and cortisol and minimal SpO2 (r = −.26, P = .06). Conclusion According to the findings, OSA is linked to HPA axis activity in severe OSA patients but not among the mild and moderate subtypes of the disorder.

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Effects of obstructive sleep apnea on serum brain-derived neurotrophic factor protein, cortisol, and lipid levels

Abstract: OSA had no significant effect on serum BDNF, cortisol, triglyceride, or total cholesterol levels while LDL-c and HDL-c levels in OSA patients compared to control were significantly different at p = 0.04, and p = 0.008, respectively.

Cited by 29 publications

References 62 publications

Is obstructive sleep apnea associated with cortisol levels? A systematic review of the research evidence

Is obstructive sleep apnea associated with cortisol levels? A systematic review of the research evidence

Sleep apnoea and the hypothalamic–pituitary–adrenal axis in men and women: effects of continuous positive airway pressure

Serum testosterone/cortisol ratio in people with obstructive sleep apnea

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