1
|
Gui J, Meng L, Huang D, Wang L, Yang X, Ding R, Han Z, Cheng L, Jiang L. Identification of novel proteins for sleep apnea by integrating genome-wide association data and human brain proteomes. Sleep Med 2024; 114:92-99. [PMID: 38160582 DOI: 10.1016/j.sleep.2023.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Sleep apnea is regarded as a significant global public health issue. The relationship between sleep apnea and nervous system diseases is intricate, yet the precise mechanism remains unclear. METHODS In this study, we conducted a comprehensive analysis integrating the human brain proteome and transcriptome with sleep apnea genome-wide association study (GWAS), employing genome-wide association study (PWAS), transcriptome-wide association study (TWAS), Mendelian randomization (MR), and colocalization analysis to identify brain proteins associated with sleep apnea. RESULTS The discovery PWAS identified six genes (CNNM2, XRCC6, C3orf18, CSDC2, SQRDL, and DGUOK) whose altered protein abundances in the brain were found to be associated with sleep apnea. The independent confirmatory PWAS successfully replicated four out of these six genes (CNNM2, C3orf18, CSDC2, and SQRDL). The transcriptome level TWAS analysis further confirmed two out of the four genes (C3orf18 and CSDC2). The subsequent two-sample Mendelian randomization provided compelling causal evidence supporting the association of C3orf18, CSDC2, CNNM2, and SQRDL with sleep apnea. The co-localization analysis further supported the association between CSDC2 and sleep apnea (posterior probability of hypothesis 4 = 0.75). CONCLUSIONS In summary, the integration of brain proteomic and transcriptomic data provided multifaceted evidence supporting causal relationships between four specific brain proteins (CSDC2, C3orf18, CNNM2, and SQRDL) and sleep apnea. Our findings provide new insights into the molecular basis of sleep apnea in the brain, promising to advance understanding of its pathogenesis in future research.
Collapse
Affiliation(s)
- Jianxiong Gui
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Linxue Meng
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Dishu Huang
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Lingman Wang
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Xiaoyue Yang
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Ran Ding
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Ziyao Han
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Li Cheng
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China
| | - Li Jiang
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China.
| |
Collapse
|
2
|
Al Wadee Z, Ooi SL, Pak SC. Serum Magnesium Levels in Patients with Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis. Biomedicines 2022; 10:biomedicines10092273. [PMID: 36140382 PMCID: PMC9496273 DOI: 10.3390/biomedicines10092273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Aims: Obstructive sleep apnoea (OSA) affects patients’ quality of life and health. Magnesium (Mg) is an essential mineral and a potent antioxidant. Mg deficiency can worsen oxidative stress caused by sleep deprivation or disorders. The impact of OSA on serum Mg levels and its health consequences remain unclear. Data Synthesis: This study systematically reviewed clinical studies investigating the serum Mg levels of OSA patients and the potential relationships with other biomarkers. Six articles were included for qualitative synthesis and quantitative analysis. Two out of four studies that compared OSA patients to healthy controls found them to have significantly lower serum Mg levels. Our meta-analysis with three studies shows that patients with OSA had significantly lower serum Mg with an effect size of −1.22 (95% CI: −2.24, −0.21). However, the mean serum Mg level of OSA patients (n = 251) pooled from five studies (1.90 mg/dL, 95% CI: 1.77, 2.04) does not differ significantly from the normal range between 1.82 to 2.30 mg/dL. OSA severity appears to affect serum Mg negatively. Serum Mg levels generally improve after treatment, coinciding with the improvement of OSA severity. Low serum Mg levels correlate with the worsening of cardiovascular risk biomarkers of C-reactive protein, ischaemia-modified albumin, and carotid intima-media thickness. The serum Mg levels also potentially correlate with biomarkers for lipid profile, glucose metabolism, calcium, and heavy metals. Conclusions: Sleep deprivation appears to deplete Mg levels of OSA patients, making them at risk of Mg deficiency, which potentially increases systemic inflammation and the risk of cardiovascular and metabolic diseases.
Collapse
Affiliation(s)
- Zahraa Al Wadee
- School of Dentistry and Medical Sciences, Charles Sturt University, Bathurst, NSW 2795, Australia
- Smiles Unlimited Dental Clinic, Fairfield, Sydney, NSW 2165, Australia
| | - Soo Liang Ooi
- School of Dentistry and Medical Sciences, Charles Sturt University, Bathurst, NSW 2795, Australia
| | - Sok Cheon Pak
- School of Dentistry and Medical Sciences, Charles Sturt University, Bathurst, NSW 2795, Australia
- Correspondence: ; Tel.: +61-2-6338-4952; Fax: +61-2-6338-4993
| |
Collapse
|
3
|
Zhu J, Sanford LD, Ren R, Zhang Y, Tang X. Multiple Machine Learning Methods Reveal Key Biomarkers of Obstructive Sleep Apnea and Continuous Positive Airway Pressure Treatment. Front Genet 2022; 13:927545. [PMID: 35910196 PMCID: PMC9326093 DOI: 10.3389/fgene.2022.927545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Obstructive sleep apnea (OSA) is a worldwide health issue that affects more than 400 million people. Given the limitations inherent in the current conventional diagnosis of OSA based on symptoms report, novel diagnostic approaches are required to complement existing techniques. Recent advances in gene sequencing technology have made it possible to identify a greater number of genes linked to OSA. We identified key genes in OSA and CPAP treatment by screening differentially expressed genes (DEGs) using the Gene Expression Omnibus (GEO) database and employing machine learning algorithms. None of these genes had previously been implicated in OSA. Moreover, a new diagnostic model of OSA was developed, and its diagnostic accuracy was verified in independent datasets. By performing Single Sample Gene Set Enrichment Analysis (ssGSEA) and Counting Relative Subsets of RNA Transcripts (CIBERSORT), we identified possible immunologic mechanisms, which led us to conclude that patients with high OSA risk tend to have elevated inflammation levels that can be brought down by CPAP treatment.
Collapse
Affiliation(s)
- Jie Zhu
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Larry D. Sanford
- Sleep Research Laboratory, Center for Integrative Neuroscience and Inflammatory Diseases, Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, United States
| | - Rong Ren
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ye Zhang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiangdong Tang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xiangdong Tang,
| |
Collapse
|
4
|
Yue CY, Zhang CY, Huang ZL, Ying CM. A Novel U-Shaped Association Between Serum Magnesium on Admission and 28-Day In-hospital All-Cause Mortality in the Pediatric Intensive Care Unit. Front Nutr 2022; 9:747035. [PMID: 35265652 PMCID: PMC8899661 DOI: 10.3389/fnut.2022.747035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 01/26/2022] [Indexed: 11/21/2022] Open
Abstract
Objective Our purpose is to evaluate whether serum magnesium when entering the ICU is related to 28-day in-hospital all-cause mortality in the pediatric ICU. Methods We used the PIC database to conduct a retrospective analysis to investigate the first-time serum magnesium levels of 10,033 critically ill children admitted to the pediatric ICU, and analyzed association between serum magnesium and all-cause mortality. Smoothing spline plots, subgroup analysis and segmented multivariate logistic regression analysis were conducted to estimate the relative risk between serum magnesium and all-cause mortality. The shape of the curve was used to describe the relationship between magnesium and 28-day in-hospital mortality. Results There is a non-linear relationship between serum magnesium and 28-day in-hospital all-cause mortality. The U-type relationship between serum magnesium and all-cause mortality was observed. The optimal range of serum magnesium with the lowest risk of mortality was 0.74–0.93 mmol/L. As the serum magnesium level reaches the turning point (0.74 mmol/L), the risk of death decreases by 60% for every 0.1 mmol/L increase in serum magnesium; when the serum magnesium level exceeds 0.93, an increase of 0.1 mmol/L increases the risk of death by 38 %. Conclusion Serum magnesium has a U-shaped relationship with 28-day in-hospital all-cause mortality. Both low and high serum magnesium can increase the risk of death. The best serum magnesium range when the risk of death is the lowest is 0.74–0.93 mmol/L.
Collapse
Affiliation(s)
- Chao Yan Yue
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chun Yi Zhang
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Zhen Ling Huang
- Department of Anesthesiology, Renji Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Chun Mei Ying
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| |
Collapse
|
5
|
Wyparło-Wszelaki M, Machoń-Grecka A, Wąsik M, Dobrakowski M. Critical aspects of the physiological interactions between lead and magnesium. J Biochem Mol Toxicol 2021; 36:e22964. [PMID: 34766669 DOI: 10.1002/jbt.22964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 09/21/2021] [Accepted: 10/26/2021] [Indexed: 12/25/2022]
Abstract
Despite technological progress, exposure to lead is an ongoing problem. There are many mechanisms governing the toxic effects of lead on the human body. One such mechanism involves the interaction of this xenobiotic with bivalent metal ions, including magnesium. Literature data suggest that the competition between these elements for binding sites at the molecular and cellular levels, as well as at the systemic level, may represent an important aspect of lead toxicity in the human body. This is especially clear in the context of oxidative stress, immune response, and gene expression modifications. This review aims to summarize current knowledge regarding these issues.
Collapse
Affiliation(s)
- Magdalena Wyparło-Wszelaki
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Anna Machoń-Grecka
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Marta Wąsik
- Department of Clinical Biochemistry and Laboratory Diagnostics, Institute of Medicine, University of Opole, Opole, Poland
| | - Michał Dobrakowski
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| |
Collapse
|
6
|
Fan L, Zhu X, Rosanoff A, Costello RB, Yu C, Ness R, Seidner DL, Murff HJ, Roumie CL, Shrubsole MJ, Dai Q. Magnesium Depletion Score (MDS) Predicts Risk of Systemic Inflammation and Cardiovascular Mortality among US Adults. J Nutr 2021; 151:2226-2235. [PMID: 34038556 PMCID: PMC8349125 DOI: 10.1093/jn/nxab138] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/17/2021] [Accepted: 04/20/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Kidney reabsorption of magnesium (Mg) is essential for homeostasis. OBJECTIVES We developed and validated models with the kidney reabsorption-related magnesium depletion score (MDS) to predict states of magnesium deficiency and disease outcomes. METHODS MDS was validated in predicting body magnesium status among 77 adults (aged 62 ± 8 y, 51% men) at high risk of magnesium deficiency in the Personalized Prevention of Colorectal Cancer Trial (PPCCT) (registered at clinicaltrials.gov as NCT01105169) using the magnesium tolerance test (MTT). We then validated MDS for risk stratification and for associations with inflammation and mortality among >10,000 US adults (weighted: aged 48 ± 0.3 y, 47% men) in the NHANES, a nationally representative study. A proportional hazards regression model was used for associations between magnesium intake and the MDS with risks of total and cardiovascular disease (CVD) mortality. RESULTS In the PPCCT, the area under the receiver operating characteristic (ROC) curve (AUC) for magnesium deficiency was 0.63 (95% CI: 0.50, 0.76) for the model incorporating the MDS with sex and age compared with 0.53 (95% CI: 0.40, 0.67) for the model with serum magnesium alone. In the NHANES, mean serum C-reactive protein significantly increased with increasing MDS (P-trend < 0.01) after adjusting for age and sex and other covariates, primarily among individuals with magnesium intake less than the Estimated Average Requirement (EAR; P-trend < 0.05). Further, we found that low magnesium intake was longitudinally associated with increased risks of total and CVD mortality only among those with magnesium deficiency predicted by MDS. MDS was associated with increased risks of total and CVD mortality in a dose-response manner only among those with magnesium intake less than the EAR. CONCLUSIONS The MDS serves as a promising measure in identifying individuals with magnesium deficiency who may benefit from increased intake of magnesium to reduce risks of systemic inflammation and CVD mortality. This lays a foundation for precision-based nutritional interventions.
Collapse
Affiliation(s)
- Lei Fan
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Xiangzhu Zhu
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andrea Rosanoff
- Center for Magnesium Education and Research (CMER), Pahoa, HI, USA
| | | | - Chang Yu
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Reid Ness
- Department of Medicine, Division of Gastroenterology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Douglas L Seidner
- Center for Human Nutrition, Department of Gastroenterology, Hepatology, and Nutrition, Digestive Disease and Surgical Institute, Cleveland Clinic, OH, USA
| | - Harvey J Murff
- Veterans Health Administration–Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville, TN, USA
| | - Christianne L Roumie
- Veterans Health Administration–Tennessee Valley Healthcare System Geriatric Research Education Clinical Center (GRECC), HSR&D Center, Nashville, TN, USA
| | - Martha J Shrubsole
- Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Qi Dai
- Address correspondence to QD (e-mail: )
| |
Collapse
|
7
|
Imani MM, Sadeghi M, Farokhzadeh F, Khazaie H, Brand S, Dürsteler KM, Brühl A, Sadeghi-Bahmani D. Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta-Analysis and Meta-Regression. Life (Basel) 2021; 11:life11040362. [PMID: 33921787 PMCID: PMC8073992 DOI: 10.3390/life11040362] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 01/08/2023] Open
Abstract
(1) Introduction: High sensitivity C-reactive protein (hs-CRP) and CRP are inflammatory biomarkers associated with several inflammatory diseases. In both pediatric and adult individuals with Obstructive Sleep Apnea (OSA) higher hs-CRP and CRP were observed, compared to controls. With the present systematic review, meta-analysis and meta-regression we expand upon previous meta-analyses in four ways: (1) We included 109 studies (96 in adults and 13 in children); (2) we reported subgroup and meta-regression analyses in adults with OSA compared to controls on the serum and plasma levels of hs-CRP; (3) we reported subgroup and meta-regression analyses in adults with OSA compared to controls on the serum and plasma levels of CRP; (4) we reported serum and plasma levels of both hs-CRP and CRP in children with OSA, always compared to controls. (2) Materials and Methods: The PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases were searched to retrieve articles published until 31 May 2020, with no restrictions. The data included basic information involving the first author, publication year, country of study, ethnicity of participants in each study, age, BMI, and AHI of both groups, and mean and standard deviation (SD) of plasma and serum levels of CRP and hs-CRP. (3) Results: A total of 1046 records were retrieved from the databases, and 109 studies were selected for the analysis (96 studies reporting the blood levels of hs-CRP/CRP in adults and 13 studies in children). For adults, 11 studies reported plasma hs-CRP, 44 serum hs-CRP, 9 plasma CRP, and 32 serum CRP levels. For children, 6 studies reported plasma hs-CRP, 4 serum hs-CRP, 1 plasma CRP, and 2 serum CRP levels. Compared to controls, the pooled MD of plasma hs-CRP levels in adults with OSA was 0.11 mg/dL (p < 0.00001). Compared to controls, the pooled MD of serum hs-CRP levels in adults with OSA was 0.09 mg/dL (p < 0.00001). Compared to controls, the pooled MD of plasma CRP levels in adults with OSA was 0.06 mg/dL (p = 0.72). Compared to controls, the pooled MD of serum CRP levels in adults with OSA was 0.36 mg/dL (p < 0.00001). Compared to controls, the pooled MD of plasma hs-CRP, serum hs-CRP, plasma hs-CRP, and serum hs-CRP in children with OSA was 1.17 mg/dL (p = 0.005), 0.18 mg/dL (p = 0.05), 0.08 mg/dL (p = 0.10), and 0.04 mg/dL (p = 0.33), respectively. The meta-regression showed that with a greater apnea-hypapnea index (AHI), serum hs-CRP levels were significantly higher. (4) Conclusions: The results of the present systematic review, meta-analysis and meta-regression showed that compared to healthy controls plasma and serum levels of hs-CRP and serum CRP level were higher in adults with OSA; for children, and compared to controls, just plasma hs-CRP levels in children with OSA were higher.
Collapse
Affiliation(s)
- Mohammad Moslem Imani
- Department of Orthodontics, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran;
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran;
| | - Farid Farokhzadeh
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran;
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran; (H.K.); (D.S.-B.)
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran; (H.K.); (D.S.-B.)
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland;
- Department of Clinical Research, University of Basel, 4031 Basel, Switzerland
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran 25529, Iran
- Correspondence:
| | - Kenneth M. Dürsteler
- Psychiatric Clinics, Division of Substance Use Disorders, University of Basel, 4002 Basel, Switzerland;
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8001 Zurich, Switzerland
| | - Annette Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland;
- Department of Clinical Research, University of Basel, 4031 Basel, Switzerland
| | - Dena Sadeghi-Bahmani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran; (H.K.); (D.S.-B.)
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland;
- Department of Clinical Research, University of Basel, 4031 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- Departments of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35209, USA
| |
Collapse
|
8
|
Cirik MÖ, Kilinç M, Doğanay GE, Ünver M, Yildiz M, Avci S. The relationship between magnesium levels and mortality in the respiratory intensive care unit. Medicine (Baltimore) 2020; 99:e23290. [PMID: 33350723 PMCID: PMC7769377 DOI: 10.1097/md.0000000000023290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/22/2020] [Indexed: 11/30/2022] Open
Abstract
Magnesium deficiency is defined as a pathophysiologic factor in numerous illnesses. This study aims to define the effects of magnesium levels on patients in the intensive care unit (ICU) regarding length of stay in the ICU, length of mechanical ventilation (MV), and 28-day mortality.The following data were collected during initial assessment of patients admitted to the ICU with acute respiratory failure (ARF). Demographic data, magnesium and potassium levels, Charlson's Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores, length of MV, length of hospital stay in the ICU, 28-day mortality, and ICU discharge status.In the initial serum analysis prior to treatment of patients in the ICU, the mortality rate of the patient group with hypermagnesemia was found to be statistically significant when compared with other magnesium levels (P = .018). Apart from renal failure, ICU mortality is higher in the hypermagnesemia group than other groups.Hypermagnesemia is an electrolyte abnormality that is generally seen in older individuals and those with serious comorbidity and it can be used in mortality prediction.
Collapse
Affiliation(s)
| | | | | | - Meriç Ünver
- Department of Anesthesiology and Intensive Care
| | - Murat Yildiz
- Department of Chest Diseases, Health Sciences University Ankara Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara
| | - Sema Avci
- Department of Emergency Medicine, Usak University Medical Faculty, Usak, Turkey
| |
Collapse
|
9
|
Wang X, Yue Z, Liu Z, Han J, Li J, Zhao Y, Wang F, Tang M, Zhao G. Continuous positive airway pressure effectively ameliorates arrhythmias in patients with obstructive sleep apnea-hypopnea via counteracting the inflammation. Am J Otolaryngol 2020; 41:102655. [PMID: 32799042 DOI: 10.1016/j.amjoto.2020.102655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/02/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This work is aimed at evaluating the therapeutic effect of continuous positive airway pressure (CPAP) in treatment of patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) combined with arrhythmias as well as clarifying the possible mechanism underpinning such an intervention. METHODS Through exclusions, a total of 108 OSAHS patients combined with arrhythmias were enrolled from June 2017 to June 2019 with full clinical information in this work. A computerized permuted block design with varying block stratification and size according to age, sex, AHI and type of arrhythmia was used to randomize 108 patients to CPAP versus sham CPAP for a period of 12-week. All were subjected to unchanged pharmacological anti-arrhythmia therapy combined with CPAP. Before and after CPAP treatment, the improvement of various arrhythmias was compared between the CPAP group and the sham-CPAP group. The levels of CRP, IL-6 and TNF-ɑ were measured simultaneously. RESULTS During follow-up, the mean (±SD) CPAP pressure used in the CPAP group was 12.3 (±3.1) cm H2O. The use of CPAP and sham CPAP was on average of 5.2 ± 0.56 and 5.1 ± 0.63 h/night, respectively. After 12 weeks of CPAP therapy, the AHI was significantly decreased and the lowest blood oxygen saturation was notably elevated in the CPAP group compared to the sham-CPAP group, P < 0.05. The CPAP therapy, compared with the sham-CPAP group, significantly reduced the incidence of all types of arrhythmia in patients with OSAHS. The level of the c-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) was significantly lower in the CPAP group than in the sham-CPAP group (P < 0.05). Pearson correlation analysis showed that the reduction in the incidence of total arrhythmias was positively correlated with the decrease of CRP, IL-6 and TNF-ɑ levels, respectively. CONCLUSION Findings from this work suggest that proper use of CPAP significantly benefits to OSAHS patients combined with arrhythmias, possibly via counteracting the inflammation.
Collapse
|
10
|
Gile J, Ruan G, Abeykoon J, McMahon MM, Witzig T. Magnesium: The overlooked electrolyte in blood cancers? Blood Rev 2020; 44:100676. [PMID: 32229066 DOI: 10.1016/j.blre.2020.100676] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/22/2020] [Accepted: 02/11/2020] [Indexed: 12/14/2022]
Abstract
Magnesium is an important element that has essential roles in the regulation of cell growth, division, and differentiation. Mounting evidence in the literature suggests an association between hypomagnesemia and all-cause mortality. In addition, epidemiologic studies have demonstrated that a diet poor in magnesium increases the risk of developing cancer, highlighting its importance in the field of hematology and oncology. In solid malignancies, hypomagnesemia at diagnosis portends a worse prognosis. However, little is known about prognosis in patients with hypomagnesemia and blood cancers in general; lymphoma more specifically. Hypomagnesemia has been associated with a higher viral load of the Epstein Barr virus, a virus associated with a multitude of hematologic malignancies. The role of magnesium in the immune system has been further elucidated in studies of patients with a rare primary immunodeficiency known as XMEN disease (X-linked immunodeficiency with Magnesium defect, Epstein-Barr virus (EBV) infection, and Neoplasia disease). These patients have a mutation in the MAGT1 gene, which codes for a magnesium transporter. The mutation leads to impaired T cell activation and an increased risk of developing hematologic malignancies. In this review we discuss the relevance of magnesium as an electrolyte, current measurement techniques, and the known data related to cause and prognosis of blood cancers. The goal is to use these data to stimulate additional high-quality and well powered studies to further investigate the role of magnesium in preventing cancer and improving outcomes of patients with malignancy and concomitant magnesium deficiency.
Collapse
Affiliation(s)
- Jennifer Gile
- Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Gordon Ruan
- Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | | | | | - Thomas Witzig
- Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| |
Collapse
|
11
|
Serum Romo1 is significantly associated with disease severity in patients with obstructive sleep apnea syndrome. Sleep Breath 2018; 22:743-748. [PMID: 29302924 DOI: 10.1007/s11325-017-1606-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/23/2017] [Accepted: 12/12/2017] [Indexed: 01/11/2023]
Abstract
PURPOSE We aim to evaluate reactive oxygen species modulator 1 (Romo1) levels in obstructive sleep apnea syndrome (OSAS) and analyze its possible relationships to OSAS severity, reactive oxygen species (ROS), and C-reactive protein (CRP). Additionally, we also investigated the effects of nasal continuous positive airway pressure (nCPAP) on serum Romo1. METHODS One hundred and five patients diagnosed with OSAS were classified into the OSAS group, and 41 subjects without OSAS were recruited for the control group. The OSAS group was further divided into mild, moderate, and severe OSAS subgroups. Fifteen patients with moderate and severe OSAS were treated with nCPAP. Serum levels of Romo1, ROS, and CRP were also measured. RESULTS Serum Romo1, ROS, and CRP were the lowest in normal subjects and increased across OSAS severities (P < 0.05). Univariate analysis showed that serum Romo1 was positively correlated with apnea-hypopnea index (AHI), oxygen desaturation index (ODI), time spent below 90% oxygen saturation (Ts90%), arousal index, ROS, and CRP, and was negatively correlated with minimal oxygen saturation (miniSaO2) (all P < 0.05). Multiple linear regression analysis showed that serum Romo1 level was significantly associated with AHI and ODI, after adjusting for age, gender, BMI, and CRP. After 6 months of nCPAP therapy, serum Romo1, ROS, and CRP were significantly decreased (P < 0.05). CONCLUSIONS The increase of serum Romo1 in OSAS patients was positively correlated with disease severity. Serum Romo1 may be an important parameter for monitoring the severity of OSAS and treatment efficiency.
Collapse
|
12
|
Wang SY, Luo J, Dong YF, Liu XY, Fan YL, Deng M, Chen DW, Li P, Cheng XS. Risk of glomerular filtration rate decline in patients with hypertrophic cardiomyopathy and obstructive sleep apnoea. Sci Rep 2017; 7:17399. [PMID: 29234143 PMCID: PMC5727083 DOI: 10.1038/s41598-017-17818-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 12/01/2017] [Indexed: 11/09/2022] Open
Abstract
Sleep apnoea is associated with chronic kidney diseases. A high obstructive sleep apnoea (OSA) prevalence is shown in patients with hypertrophic cardiomyopathy (HCM). Whether the presence of OSA would affect the renal function of patients with HCM is unknown. Forty-five consecutive patients with HCM were divided into the HCM OSA− and OSA+ groups. Forty-three patients with OSA without HCM were recruited as controls. Clinical indices, including estimated glomerular filtration rate (eGFR) and urine 8-hydroxy-2-deoxyguanosine (8-OHdG), were measured. The eGFR was significantly lower in the HCM OSA+ group than in the HCM OSA− (P < 0.05) and OSA (P < 0.001) groups. Multivariate linear regression analysis identified that the apnoea-hypopnoea index was independently associated with eGFR in all patients with HCM (β = −1.329, 95% confidence interval: −1.942, −0.717, P < 0.001). The urine 8-OHdG level, an oxidative stress marker, was significantly higher in the HCM OSA+ group than in the HCM OSA− (P < 0.001) and OSA (P < 0.001) groups and significantly correlated with the AHI (r = 0.467, P = 0.003) and eGFR (r = −0.457, P = 0.004) in all patients with HCM. Our study suggests a risk of eGFR decline in patients with HCM and OSA.
Collapse
Affiliation(s)
- Shao-Yun Wang
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, Jiangxi, China
| | - Jing Luo
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, Jiangxi, China
| | - Yi-Fei Dong
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, Jiangxi, China. .,Key Laboratory of Molecular Biology in Jiangxi Province, Nanchang of Jiangxi, Jiangxi, China.
| | - Xu-Yang Liu
- Department of Cardiovascular Medicine, the Affiliated Hospital of Jinggangshan University, Ji'an of Jiangxi, Jiangxi, China
| | - Ying-Li Fan
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, Jiangxi, China
| | - Ming Deng
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, Jiangxi, China
| | - Da-Wei Chen
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, Jiangxi, China
| | - Ping Li
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, Jiangxi, China
| | - Xiao-Shu Cheng
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, Jiangxi, China.
| |
Collapse
|
13
|
Xu Q, Du J, Ling X, Lu Y. Evaluation of MIh Scoring System in Diagnosis of Obstructive Sleep Apnea Syndrome. Med Sci Monit 2017; 23:4715-4722. [PMID: 28966342 PMCID: PMC5635950 DOI: 10.12659/msm.904087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background The objective of the present study was to investigate whether the analysis of magnesium (Mg), high-sensitivity C-reactive protein (hsCRP), and ischemia-modified albumin (IMA) concentrations can be used as a non-invasive and convenient method for diagnosing obstructive sleep apnea syndrome (OSAS). Material/Methods After polysomnography, venous blood was collected from 33 patients with OSAS and 30 control individuals. Serum levels of Mg, hsCRP, and IMA were investigated. The relationship between these factors and apnea–hypopnea index (AHI) was analyzed using the Pearson correlation coefficient. The role of the factors was determined using a receiver operating characteristic (ROC) curve and multivariate logistic regression analysis. Results The levels of hsCRP and IMA were significantly higher in patients with OSAS than in control subjects, while the levels of Mg were lower (P<0.05 for all). A significant correlation was noted between serum IMA (r=0.614; P<0.001) and hsCRP (r=0.453; P<0.001) levels and the AHI. The ROC showed that serum Mg (AUC=0.74(0.62–0.85)), hsCRP (AUC=0.77(0.65–0.87)), and IMA (AUC=0.78(0.66–0.87)) levels could be used as markers to diagnose OSAS. Moreover, our new model, MIh, which is obtained by multivariate analysis, yielded an AUC value of 0.93 (0.83–0.98). Continuous positive airway pressure (CPAP) treatment reversed the changes in the serum levels of Mg, hsCRP, and IMA. Conclusions Patients with OSAS show reduced serum Mg levels and elevated serum hsCRP and IMA levels. These observed alterations can be reversed by CPAP treatment. A novel model, named MIh, may be a promising tool for OSAS diagnosis.
Collapse
Affiliation(s)
- Qinxing Xu
- Department of Respiratory Medicine, Hangzhou Fuyang First People's Hospital, Hangzhou, Zhejiang, China (mainland)
| | - Junwei Du
- Department of Respiratory Medicine, Hangzhou Fuyang First People's Hospital, Hangzhou, Zhejiang, China (mainland)
| | - Xiaobo Ling
- Department of Respiratory Medicine, Hangzhou Fuyang First People's Hospital, Hangzhou, Zhejiang, China (mainland)
| | - Yangfei Lu
- Department of Respiratory Medicine, Hangzhou Fuyang First People's Hospital, Hangzhou, Zhejiang, China (mainland)
| |
Collapse
|
14
|
Toprak O, Sarı Y, Koç A, Sarı E, Kırık A. The impact of hypomagnesemia on erectile dysfunction in elderly, non-diabetic, stage 3 and 4 chronic kidney disease patients: a prospective cross-sectional study. Clin Interv Aging 2017; 12:437-444. [PMID: 28280316 PMCID: PMC5340248 DOI: 10.2147/cia.s129377] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Erectile dysfunction (ED) is common in older men with chronic kidney disease. Magnesium is essential for metabolism of nitric oxide which helps in penile erection. There is little information available about the influence of serum magnesium on ED. The aim of the study was to assess the influence of hypomagnesemia on ED in elderly chronic kidney disease patients. SUBJECTS AND METHODS A total of 372 patients aged 65-85 years, with an estimated glomerular filtration rate of 60-15 mL/min/1.73 m2, were divided into two groups according to serum magnesium levels: hypomagnesemia, n=180; and normomagnesemia, n=192. ED was assessed through the International Index of Erectile Function-5. Hypomagnesemia is defined as serum magnesium <1.8 mg/dL. RESULTS The prevalence of ED was higher among hypomagnesemic subjects compared to that among normomagnesemics (93.3% vs 70.8%, P<0.001). Severe ED (62.8% vs 43.8%, P=0.037), mild-to-moderate ED (12.2% vs 5.2%, P=0.016), abdominal obesity (37.2% vs 22.9%, P=0.003), metabolic syndrome (38.4% vs 19.2%, P=0.026), proteinuria (0.83±0.68 vs 0.69±0.48 mg/dL, P=0.023), and C-reactive protein (6.1±4.9 vs 4.1±3.6 mg/L, P<0.001) were high; high-density lipoprotein cholesterol (48.8±14.0 vs 52.6±13.5 mg/dL, P=0.009), and albumin (4.02±0.53 vs 4.18±0.38 g/dL, P=0.001) were low in the hypomagnesemia group. Serum magnesium ≤1.85 mg/dL was the best cutoff point for prediction of ED. Hypomagnesemia (relative risk [RR] 2.27), age ≥70 (RR 1.74), proteinuria (RR 1.80), smoking (RR 21.12), C-reactive protein (RR 1.34), abdominal obesity (RR 3.92), and hypertension (RR 2.14) were predictors of ED. CONCLUSION Our data support that ED is related to hypomagnesemia in elderly patients with moderately to severely reduced kidney function.
Collapse
Affiliation(s)
| | | | - Akif Koç
- Division of Urology, Department of Medicine, Balikesir University School of Medicine, Balikesir, Turkey
| | - Erhan Sarı
- Division of Urology, Department of Medicine, Balikesir University School of Medicine, Balikesir, Turkey
| | | |
Collapse
|