Peripheral biomarkers to diagnose obstructive sleep apnea in adults: A systematic review and meta-analysis

Gaspar, Laetitia S.; Santos-Carvalho, Ana; Santos, Bárbara; Carvalhas-Almeida, Catarina; Barros-Viegas, Ana Teresa; Oliveiros, Bárbara; Donato, Helena; Santos, Clara Faria Souza Mendes dos; Moita, Joaquim; Cavadas, Cláudia; Álvaro, Ana Rita

doi:10.1016/j.smrv.2022.101659

Cited by 16 publications

(18 citation statements)

References 61 publications

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“…This specific biomarker has been identified for diagnosing and monitoring various diseases, including lung cancer, renal carcinoma, OSAHS, and coronary heart disease. [15,37,38] The present study compared endocan levels in the serum and plasma of individuals with OSAHS and controls. The results revealed that serum/plasma endocan levels were comparatively elevated in individuals with OSAHS compared with controls.…”

Section: Discussionmentioning

confidence: 99%

Association between elevated endocan levels and obstructive sleep apnea hypopnea syndrome in Turkey and China: A meta-analysis

He,

Li,

et al. 2023

Medicine

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Background: Endothelial dysfunction has been implicated in the pathogenesis of obstructive sleep apnea–hypopnea syndrome (OSAHS). Previous research has linked endothelial dysfunction to the vascular pathology marker endothelial cell-specific molecule-1 (endocan). This meta-analysis compared endocan concentrations among adult patients with OSAS and controls, and ascertained whether any differences exist. This study aimed to highlight the association between high endocan levels and OSAHS. Methods: A comprehensive, systematic literature search of the PubMed, Cochrane Library, China National Knowledge Infrastructure, Web of Science, Embase, and Wan Fang databases for relevant studies, published between January 2000 and June 10, 2013, was performed. Additionally, standardized mean differences, correlation coefficients, and adjusted odds ratios were used to assess the effect size. Statistical analyses were performed using R version 4.13 (Copenhagen: The Cochrane Collaboration) and Stata version 10.0 (StataCorp LLC, College Station, TX). Results: Twelve studies fulfilled the inclusion criteria. Nine studies reported endocan levels in patients with OSAHS and controls, and 6 reported serum endocan levels in relation to polysomnography (PSG) indexes (apnea-hypopnea index, body mass index, minimum oxygen (O2) saturation, and flow-mediated dilatation [FMD]). Five studies reported that serum endocan levels functioned independently as risk factors for OSAHS. These levels were determined to be elevated in adults with OSAHS compared with controls (standardized mean difference 1.30 [95% confidence interval (CI) 1.06–1.54]) and increased more significantly with increasing disease severity in individuals with OSAHS. Subjects were divided into different subgroups based on race, geographical region, sample type, and study design. Results indicated increased endocan levels across all OSAHS subgroups compared with the control group. The data highlighted a positive association between serum endocan levels and apnea-hypopnea index, and a negative association with FMD and minimum O2 saturation. The overall adjusted odds ratio between serum endocan levels and OSAHS was 1.04 (95% CI 1.02–1.06). Conclusion: Results of this meta-analysis provide further evidence supporting elevated endocan levels in adults with OSAHS. Serum endocan levels were correlated with various PSG indices and may be associated with OSAHS.

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Section: Discussionmentioning

confidence: 99%

Association between elevated endocan levels and obstructive sleep apnea hypopnea syndrome in Turkey and China: A meta-analysis

He,

Li,

et al. 2023

Medicine

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“…As OSA remains highly underdiagnosed (Young et al, 2004), increased efforts are aimed at developing complementary diagnostic methods. Machine learning models (Pang et al, 2022) and possible OSA biomarkers may facilitate OSA screening and diagnosis, however, future studies are needed for their validation (Gaspar et al, 2022; Nowak et al, 2021). As standard PSG does not assess night‐to‐night variability in sleep parameters, which is significant but underreported, multiple‐night sleep recording via portable devices may be of interest (Chouraki et al, 2022).…”

Section: Review On Obstructive Sleep Apneamentioning

confidence: 99%

Is obstructive sleep apnea a circadian rhythm disorder?

Šmon

Kočar

Pintar

et al. 2023

Journal of Sleep Research

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Obstructive sleep apnea is the most common sleep-related breathing disorder worldwide and remains underdiagnosed. Its multiple associated comorbidities contribute to a decreased quality of life and work performance as well as an increased risk of death. Standard treatment seems to have limited effects on cardiovascular and metabolic aspects of the disease, emphasising the need for early diagnosis and additional therapeutic approaches. Recent evidence suggests that the dysregulation of circadian rhythms, processes with endogenous rhythmicity that are adjusted to the environment through various cues, is involved in the pathogenesis of comorbidities.In patients with obstructive sleep apnea, altered circadian gene expression patterns have been demonstrated. Obstructive respiratory events may promote circadian dysregulation through the effects of sleep disturbance and intermittent hypoxia, with subsequent inflammation and disruption of neural and hormonal homeostasis. In this review, current knowledge on obstructive sleep apnea, circadian rhythm regulation, and circadian rhythm sleep disorders is summarised. Studies that connect obstructive sleep apnea to circadian rhythm abnormalities are critically evaluated. Furthermore, pathogenetic mechanisms that may underlie this association, most notably hypoxia signalling, are presented. A bidirectional relationship between obstructive sleep apnea and circadian rhythm dysregulation is proposed. Approaching obstructive sleep apnea as a circadian rhythm disorder may prove beneficial for the development of new, personalised diagnostic, therapeutic and prognostic tools. However, further studies are needed before the clinical approach to obstructive sleep apnea includes targeting the circadian system.

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“…Interest in biomarkers for OSA is increasing with early-stage research suggesting they could be beneficial in diagnostics [68,69], and could form a part of screening strategies in the future.…”

Section: Diagnosticsmentioning

confidence: 99%

Perioperative management of Obstructive Sleep Apnoea: Present themes and future directions

Chambers,

Bamber,

Singh

2023

Current Opinion in Pulmonary Medicine

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Purpose of review Obstructive sleep apnoea (OSA) is an increasingly common pathology that all those involved in perioperative care will come across. Patients with the condition present a challenge at many stages along the perioperative journey, not least because many patients living with OSA are unaware of their diagnosis. Key interventions can be made pre, intra-, and postoperatively to improve outcomes. Knowledge of screening tools, diagnostic tests, and the raft of treatment options are important for anyone caring for these patients. Recent findings Recent literature has highlighted the increasing complexity of surgical patients and significant underdiagnosis of OSA in this patient population. Work has demonstrated how and why patients with OSA are at a higher perioperative risk and that effective positive airways pressure (PAP) therapy can reduce these risks, alongside evidencing how best to optimise adherence to therapy, a key issue in OSA. Summary OSA, and particularly undiagnosed OSA, presents a huge problem in the perioperative period. Perioperative PAP reduces the risk of postoperative complications but adherence remains an issue. Bespoke perioperative pathways should be developed to identify and optimise high risk patients, although at present evidence on how best to achieve this is lacking.

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Peripheral biomarkers to diagnose obstructive sleep apnea in adults: A systematic review and meta-analysis

Cited by 16 publications

References 61 publications

Association between elevated endocan levels and obstructive sleep apnea hypopnea syndrome in Turkey and China: A meta-analysis

Association between elevated endocan levels and obstructive sleep apnea hypopnea syndrome in Turkey and China: A meta-analysis

Is obstructive sleep apnea a circadian rhythm disorder?

Perioperative management of Obstructive Sleep Apnoea: Present themes and future directions

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