Endothelial Function and Arterial Stiffness Should Be Measured to Comprehensively Assess Obstructive Sleep Apnea in Clinical Practice

Abstract

Objective: An effective clinical tool to assess endothelial function and arterial stiffness in patients with obstructive sleep apnea (OSA) is lacking. This study evaluated the clinical significance of subclinical markers for OSA management in males without serious complications.Patients/Methods: Males without serious complications were consecutively recruited. Clinical data, biomarker tests, reactive hyperemia index (RHI), and augmentation index at 75 beats/min (AIx75) measured by peripheral arterial tonometry were collected. An apnea hypopnea index (AHI) cutoff of ≥15 events/h divided the patients into two groups.Results: Of the 75 subjects, 42 had an AHI ≥15 events/h. Patients with an AHI ≥15 events/h had higher high-sensitivity C-reactive protein, tumor necrosis factor-alpha (TNF-α), vascular endothelial growth factor, and AIx75 values than the control group but no statistical difference in RHI was observed. After controlling for confounders, TNF-α was negatively correlated with the average oxygen saturation (r = −0.258, P = 0.043). RHI was correlated with the rapid eye movement (REM) stage percentage (r = 0.306, P = 0.016) but not with AHI (P > 0.05). AIx75 was positively correlated with the arousal index (r = 0.289, P = 0.023) but not with AHI (r = 0.248, P = 0.052).Conclusions: In males with OSA without severe complications, TNF-α and AIx75 are independently related to OSA. The role of RHI in OSA management requires further elucidation. These markers combined can comprehensively evaluate OSA patients to provide more evidence for the primary prevention of coronary heart disease and treatment response assessment.

The Relationship Between HIF1α and Clock Gene Expression in Patients with Obstructive Sleep Apnea

“…The present study was carried out as described previously. 31 The exclusion criteria were as follows: (1) patients who had been treated for sleep apnea by continuous positive airway pressure (CPAP); (2) patients with self-reported chronic diseases including uncontrolled hypertension, chronic liver diseases, chronic kidney diseases, chronic lung diseases, perivascular diseases, heart diseases, diabetes, thromboembolism diseases, tumor, nerve system diseases and mental diseases; (3) patients with acute infectious over the previous two weeks; and (4) patients who performed shift work and slept for less than 6 h. Written and informed consent was provided by all participants. The study was approved by the PUMCH ethics committee (protocol number: JS-2013) and conducted in accordance with the Declaration of Helsinki.…”

“…An AHI ≥15 events/h was used as a cutoff to divide the patients into two groups: the control group featuring patients with an AHI <15 events/h and an OSA group of patients with an AHI ≥15 events/h based on the International Classification of Sleep Disorders (3rd Edition). 31 In addition, we classified patients with a T90 > 0 into a nocturnal hypoxemia (NH) group and those with a T90 = 0 as a no NH group.…”