Sleep Apnoea-Hypopnoea Index Is an Independent Predictor of High-Sensitivity C-Reactive Protein Elevation

Boudjeltia, Karim Zouaoui; Meerhaeghe, Alain Van; Doumit, Sonia; Guillaume, M.; Cauchie, Philippe; Brohée, Dany; Vanhaeverbeek, Michel; Kerkhofs, Myriam

doi:10.1159/000090201

Cited by 45 publications

(35 citation statements)

References 26 publications

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“…The pathophysiological changes in OSA can activate peripheral neutrophils and monocytes, leading to enhanced generation of cytokines [4, 8], resulting in the elevated levels of pro-inflammatory mediators [2,3,4,5,6,7]. Nocturnal hypoxia has emerged as a primary candidate to enhance inflammatory cascades in OSA [1, 6, 12, 41].…”

Section: Discussionmentioning

confidence: 99%

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Resistin Is Closely Related to Systemic Inflammation in Obstructive Sleep Apnea

et al. 2008

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Background: Obstructive sleep apnea (OSA) is closely related to systemic inflammation. Resistin is an adipocyte-derived cytokine (adipokine) that may link obesity with inflammation. Objective: We aimed to investigate whether incremental changes in OSA severity, from normal to severe, primarily affect the levels of resistin and other adipokines. Methods: Serum levels of resistin, interleukin-6 (IL-6) and leptin were examined in 31 men with OSA and 10 men without OSA, matched for age, body mass index (BMI) and several metabolic profiles. In 11 of the 31 men with OSA, these mediators were reexamined after 3 months of nasal continuous airway pressure (nCPAP) therapy. Results: Levels of resistin and IL-6 were simultaneously elevated in men with OSA compared with those in men without OSA (p < 0.05), while levels of leptin did not differ. The resistin and IL-6 levels tended to increase with increasing disease severity (p < 0.05), which was based on the apnea-hypopnea index (AHI). The average oxyhemoglobin saturation during sleep (p < 0.01) and IL-6 (p < 0.05) emerged as significant determinants of resistin, even after adjustments for age, BMI, leptin levels and metabolic risk factors. After nCPAP therapy, the elevated levels of resistin and IL-6 decreased, reaching almost baseline levels of controls. Before treatment, AHI correlated positively with the reduction rate in resistin (p < 0.05). Conclusion: In OSA patients, resistin production can be enhanced by hypoxic stress during sleep, possibly mediating systemic inflammatory processes. nCPAP therapy may play a beneficial role in the control of resistin production.

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Section: Discussionmentioning

confidence: 99%

“…A wide variety of pro-inflammatory mediators are elevated in the circulation of patients with OSA [2,3,4,5,6,7]. Additionally, OSA patients have peripheral leukocytes which can generate larger amounts of cytokines [4, 8], adhesion molecules [9] and free radicals [10].…”

Section: Introductionmentioning

confidence: 99%

Resistin Is Closely Related to Systemic Inflammation in Obstructive Sleep Apnea

et al. 2008

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“…Many of the deleterious consequences of OSAHS are a result of frequent episodes of hypoxemia that occur during the night [40]. Even though the pathophysiology of cardiovascular complications is multifactorial, involving sympathetic excitation, endothelial dysfunction, inflammation and insulin resistance, it is probable that intermittent episodes of hypoxia and, particularly, intermittent episodes of re-oxygenation play a central role in the process [41,42,43,44]. If so, the prevention of hypoxemia episodes and re-oxygenation in OSAHS could result in the prevention of inflammatory activation, and, thereby, this treatment facilitates, at least in part, a reduction in cardiovascular risks [40].…”

Section: Discussionmentioning

confidence: 99%

Bariatric Surgery in the Treatment of Obstructive Sleep Apnea in Morbidly Obese Patients

Fritscher

Canani

Mottin³

et al. 2007

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Background: Weight loss has been shown effective in the treatment of the obstructive sleep apnea-hypopnea syndrome. Regrettably, many obese patients are unable to achieve sustained and useful weight loss by dietary means. Recently, bariatric surgery has emerged as an alternative to treat obesity and many of its comorbidities, although its role for sleep apnea treatment is still not defined. Objectives: To evaluate the impact of bariatric surgery on obstructive sleep apnea in morbidly obese patients. Methods: In this cohort study, polysomnography, Epworth Sleepiness Scale questionnaire and clinical assessment were performed in 12 of 13 morbidly obese patients with moderate to severe obstructive sleep apnea treated with bariatric surgery through Roux-en-Y gastric bypass procedure after a minimum of 18 months post surgery. Results: The mean (±SD) loss of excess body weight was 70.5 ± 24%. The mean level obtained in the Epworth Scale was 4.8. There was a significant reduction in the apnea-hypopnea index, from a median of 46.5 (range: 33–140) to 16 (range: 0.9–87) events per hour (p < 0.05), an improvement in mean oxygen saturation from 85.7 ± 5.1 to 94.5 ± 3.6% (p < 0.05) and in minimum oxygen saturation from 64.7 ± 13.4 to 78.7 ± 13.7% (p < 0.05). The magnitude of the weight loss and the improvements in mean and minimum oxygen saturation were positively correlated, (r = 0.76; p ≤ 0.05, and r = 0.59; p ≤ 0.05, respectively). Conclusions: Weight loss achieved by bariatric surgery is associated with significant long-term improvements in obstructive respiratory event, oxygenation and resolution of daytime somnolence.

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“…Boudjeltia et al [15] observed an independent association between the AHI and hsCRP in 49 patients referred to the sleep laboratory for suspected sleep apnea. In multivariate analysis, including age, BMI, gender, hypertension, diabetes, tobacco, microarousal index, AHI, total cholesterol, triglycerides and LDL cholesterol, AHI was the only variable independently associated with hsCRP.…”

Section: Discussionmentioning

confidence: 99%

Homocysteine Levels and Echocardiographic Findings in Obstructive Sleep Apnea Syndrome

Sarıman¹,

Levent²,

Aksungar³

et al. 2009

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Background: The obstructive sleep apnea syndrome (OSAS) is characterized by repeated upper airway obstruction during sleep together with decreases in oxygen saturation leading to a series of pathological events, primarily in the cardiovascular system. Elevated plasma homocysteine levels have recently been considered as an independent risk factor for vascular disease, and increased levels are attributed to cardiovascular diseases. Objectives: We aimed to investigate the possible relationship between homocysteine levels and echocardiographic findings in OSAS patients at different stages of disease. Methods: Thirty-eight patients (23 males and 15 females) with polysomnographically verified OSAS (mean age, 49 ± 12 years, range 27–74) and a mean body mass index of 31.27 ± 5.24 kg/m² (range 22.60–47.90) were prospectively studied. Plasma levels of homocysteine, cholesterols, triglycerides, vitamin B₁₂ and high-sensitive C-reactive protein (hsCRP), as well as echocardiographic and lung function parameters were assessed. Results: Homocysteine levels were elevated in all OSAS groups and were statistically significantly different between the mild and moderate/severe groups. Significant differences were present between the variables nocturnal oxygen desaturation (NOD), respiratory arousal and light sleep among the mild and moderate/severe groups. We found a significant positive correlation between homocysteine levels and NOD duration, and hsCRP levels were positively correlated with the apnea-hypopnea index and NOD duration. Conclusions: In all OSAS groups, homocysteine levels were elevated regardless of the presence of cardiac dysfunction. Echocardiographic abnormalities were primarily left-ventricular (LV) hypertrophy and LV diastolic dysfunction and could be observed in all OSAS severity groups.

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Sleep Apnoea-Hypopnoea Index Is an Independent Predictor of High-Sensitivity C-Reactive Protein Elevation

Cited by 45 publications

References 26 publications

Resistin Is Closely Related to Systemic Inflammation in Obstructive Sleep Apnea

Resistin Is Closely Related to Systemic Inflammation in Obstructive Sleep Apnea

Bariatric Surgery in the Treatment of Obstructive Sleep Apnea in Morbidly Obese Patients

Homocysteine Levels and Echocardiographic Findings in Obstructive Sleep Apnea Syndrome

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