Severe obstructive sleep apnea increases cystatin C in clinically latent renal dysfunction

Kato, Kota; Takata, Yasuyuki; Usui, Yasuhiro; Shiina, Kazuki; Asano, Katsuaki; Hashimura, Yuki; Saruhara, Hirokazu; Nishihata, Yosuke; Tomiyama, Hirofumi; Yamashina, Akira

doi:10.1016/j.rmed.2010.11.024

Cited by 34 publications

(23 citation statements)

References 26 publications

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“…Several studies focus on cystatin C level in OSA patients. A study from Japan [13] revealed that severe OSA has increasing serum cystatin C levels in patients without CKD. Canales et al [29] also showed that cystatin C was associated with respiratory disturbance index (RDI) in elderly men, and they indicated that reduced renal function, defined by high cystatin C, might be correlated with sleep-disordered breathing.…”

Section: Discussionmentioning

confidence: 99%

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Effect of continuous positive airway pressure on serum cystatin C among obstructive sleep apnea syndrome patients

et al. 2014

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Section: Discussionmentioning

confidence: 99%

“…Studies have shown that OSA patients have a high serum cystatin C independent of complications [13][14][15], and it is easily to speculate that OSA patients with high cystatin C level may suffer obvious kidney impairment in the near future.…”

Section: Introductionmentioning

confidence: 99%

Effect of continuous positive airway pressure on serum cystatin C among obstructive sleep apnea syndrome patients

et al. 2014

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“…En otro estudio, SAOS severo es una variable independiente para el aumento de cistatina C. La cistatina C es un inhibidor de la proteasa de cisteína que se produce constantemente por las células nucleadas y se libera en la sangre, donde normalmente se reabsorbe y cataboliza en los túbulos renales sin necesidad de volver a entrar en la sangre. En este estudio, encontraron que los pacientes con SAOS tienen concentraciones más elevadas, con un OR de 2,04 (IC1,04-4,01) 48 . También se ha estudiado la relación entre SAOS y trasplante renal.…”

Section: Enfermedad Renal Crónicaunclassified

Compromiso multisistémico en apnea obstructiva del sueño

Labarca

Descalzi

2014

Rev. méd. Chile

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. El diagnóstico se establece mediante la demostración de eventos obstructivos mediante polisomnografía o la poligrafía respiratoria, la que demuestra el índice de apnea e hipoapnea (AHI), indicador de severidad de SAOS. Un AHI < 5 es normal; leve, 5 a 10; moderado, 15 a 30 y severo > 30 [1][2][3] . La terapia se basa en tratamiento conservador e incluyen la pérdida de peso, higiene del sueño, corrección con terapia postural y manejo de factores como la congestión nasal. En aquellos pacientes con SAOS moderado o severo se recomienda el uso de CPAP (continuous positive airway pressure). Este dispositivo es considerado el tratamiento más efectivo demostrado en varios ensayos clínicos de distribución aleatoria 3,4 . La obstrucción de la vía aérea y la fragmentación del sueño tienen como consecuencia una alteración en los ciclos de hipoxia y reoxigenación.Esta alteración produce isquemia transitoria sobre los tejidos, concepto conocido como hipoxia crónica intermitente (HI) 5,6 . La HI aumenta las concentraciones de radicales libre de oxígeno (ROS) que actúan como mediadores de citoquinas pro-inflamatorias, generando un estado de inflamación sistémica, una mayor activación del sistema simpático, disfunción endotelial, desregulación metabólica y un estado de hipercoagulabilidad, mecanismos identificados como patogénicos en distintos sistemas del organismo en modelos clínicos como experimentales 7 (Figura 1). El objetivo de la presente revisión es describir las consecuencias que tiene SAOS sobre los distintos sistemas, así como los riesgos asociados a la patología y estudios que avalan estas asociaciones. Compromiso metabólico en SAOS ObesidadLa obesidad central es el factor de riesgo más prevalente en SAOS, cerca de 40% de los pacientes

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“…Additionally, Cyst C has emerged as a potential indicator of cardiovascular risk [19]. In OSAS patients without CKD, serum Cyst C was found increased, reflecting latent renal dysfunction as well as augmented cardiovascular risk [20]. …”

Section: Introductionmentioning

confidence: 99%

Cystatin C Levels in Middle-Aged Patients with Obstructive Sleep Apnea Syndrome

et al. 2016

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Background. Obstructive sleep apnea syndrome (OSAS) is associated with systemic inflammation and increased risk of cardiovascular and chronic kidney disease. Cystatin C (Cyst C) is a novel biomarker of both latent renal damage and cardiovascular disease. Aim of the study was to measure serum levels of Cyst C, as well as IL-8 and CRP, in otherwise healthy OSAS patients. Methods. 84 individuals examined with polysomnography for OSAS symptoms without known comorbidities were prospectively recruited. Results. According to apnea hypopnea index (AHI) subjects were divided in two groups: OSAS group (AHI > 5/hour, n = 64) and controls (AHI < 5/hour, n = 20), which were age- and BMI-matched. Cyst C levels were higher in OSAS patients versus controls (1176.13 ± 351.33 versus 938.60 ± 245.83 ng/mL, resp.; p = 0.017) while serum IL-8 and CRP levels did not differ significantly. Positive correlation was found between Cyst C levels and respiratory disturbance index (RDI) (r = 0.240, p = 0.039) and percentage of time with oxygen saturation <90% (r = 0.290, p = 0.02) and negative correlation was found between Cyst C levels and average oxygen saturation during sleep (r = −0.291, p = 0.012). After adjustment for age and BMI, RDI was the only independent predictor of Cyst C levels (β = 0.256, p = 0.039). Conclusion. Cyst C serum levels are increased in OSAS patients without comorbidities, suggesting an increased renal and cardiovascular disease risk.

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Severe obstructive sleep apnea increases cystatin C in clinically latent renal dysfunction

Abstract: This study indicates that severe OSA independently increases serum cystatin C levels in patients without CKD. Cystatin C is considered to be a biomarker that reflects both clinically latent renal dysfunction and cardiovascular risk that are influenced by OSA.

Cited by 34 publications

References 26 publications

Effect of continuous positive airway pressure on serum cystatin C among obstructive sleep apnea syndrome patients

Effect of continuous positive airway pressure on serum cystatin C among obstructive sleep apnea syndrome patients

Compromiso multisistémico en apnea obstructiva del sueño

Cystatin C Levels in Middle-Aged Patients with Obstructive Sleep Apnea Syndrome

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