The Relation between Pregnancy-Associated Plasma Protein A and Obstructive Sleep Apnea Syndrome

Abstract

Aim We aimed to investigate the relationship between serum pregnancy-associated plasma protein A (PAPP-A) levels and obstructive sleep apnea syndrome (OSAS). Materials and Method 44 patients with OSAS and 44 healthy adults were included in this study. The participants having rheumatic or systemic inflammatory disease, advanced liver or kidney failure, diabetes, heart failure, hypertension, pregnancy, prerenal azotemia, known history of coronary artery disease, any pulmonary disease, rhinitis, or atopy, history of major trauma or surgery within the last six 6 months, and inhaled nasal or systemic corticosteroid use or other anti-inflammatory medications and those with <18 years of age were excluded. Serum PAPP-A levels were determined by the Elisa method with the immune sandwich measuring method. Statistical analysis of the study was performed with SPSS 17.0 statistical analysis package program, and p < 0.05 was considered as significant. Results Serum PAPP-A levels of patients with OSAS (2.350 ng/ml (0.641–4.796)) were significantly higher (p < 0.001) when compared with healthy controls (0.971 ng/ml (0.109–2.679)). There was a statistically significant difference in serum PAPP-A levels between groups of OSAS patients according to the classification of OSAS severity. Between the groups of patients with OSAS, serum levels of PAPP-A in moderate group was significantly higher when compared with severe OSAS group (p < 0.001). There was positive correlations between PAPP-A levels and night minimum (p=0.042, r=0.309), and average oxygen levels (p=0.006, r=0.407). There was a negative correlation between PAPP-A levels and AHI (p=0.002, r=−0.460). Conclusion Higher PAPP-A levels in OSAS patients that were found in this study show inflammatory component in OSAS.

Oxidative Stress Markers among Obstructive Sleep Apnea Patients

“…In this study, a negative correlation between AHI and the levels of PAPP-A was reported. Surprisingly, patients with moderate OSA were found to have higher levels of PAPP-A compared with those who had mild or severe OSA [34]. In contrast, Volná et al reported no significant correlation between AHI and the severity of OSA [24].…”

“…Results from previous reports assessing the levels of PAPP-A in OSA patients remain ambiguous. Cengiz et al [34] showed that PAPP-A levels were significantly higher in OSA patients compared with a control group. In this study, a negative correlation between AHI and the levels of PAPP-A was reported.…”

Elevated PAPP-A Levels In Patients With Obstructive Sleep Apnea Syndrome

“…In that study, it was emphasized that there was a negative correlation between PAPP-A values and the AHI score. Decreasing PAPP-A levels in the severe OSAS group with AHI ≥ 30 were attributed to the compensatory mechanisms not having exceeded the oxidative and inflammatory activities 20 . Eickhoff et al also reported an association between the risk factors of OSAS such as hypoxia and chronic inflammation and vascular endothelial dysfunction and atherosclerosis 35 .…”

“…In a study by Cengiz et al 20 of patients with OSAS, the difference in PAPP-A level between OSAS groups and the control group was detected at 96.7%. Based on that study, the power analysis of this study determined that for test power to be 0.95 with error accepted as 0.05, each group required at least 5 patients.…”