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Kostlivy T, Pesta M, Windrichova J, Skopek P, Klail P, Skalova A, Gal B, Kucera R, Plickova K, Simanek V, Slouka D. The impact of obesity, age, and gender on plasmatic levels of selected glycoprotein biomarkers and miRNA-499 in OSA patients. J Appl Biomed 2024; 22:81-88. [PMID: 38912863 DOI: 10.32725/jab.2024.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/06/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND The current obstructive sleep apnea (OSA) diagnostic uses polysomnography or limited polygraphy and requires specialized personnel and technical equipment. Glycoprotein biomarkers and microRNAs are being explored as a possible new method for screening. We aimed to evaluate whether certain biomarkers and microRNA, previously identified as related to OSA, could be influenced by factors such as gender, age, and obesity level in patients with OSA. METHODS In this retrospective analytical study, patients with moderate to severe OSA (n = 130) were compared with the control group. Serum levels of selected biomarkers and microRNA were taken from both groups. The group of OSA patients was then stratified by gender, obesity level, and age to see the possible influence of those variables on biomarker levels. RESULTS Levels of all studied biomarkers - C-reactive protein (CRP), high-sensitivity troponin I (hsTnI), pentraxin-3 (PTX-3), and microRNA-499 were significantly higher in patients with OSA compared to the control group. In the OSA group only hsTnI showed a statistically significant relationship with gender. Levels of CRP and hsTnI showed a significant dependence on the level of obesity. Dependency on age was proven for hsTnI. CRP, PTX-3, and microRNA-499 did not have any statistically significant relationship with age. CONCLUSION We found that serum levels of pentraxin-3 and microRNA-499 in patients with moderate to severe obstructive sleep apnoea are independent of gender, obesity, and age. CRP was affected by the level of obesity and hsTnI was influenced by all 3 variables. We consider these findings important for further research of OSA biomarkers.
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Affiliation(s)
- Tomas Kostlivy
- Charles University, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Department of Otorhinolaryngology, Pilsen, Czech Republic
| | - Martin Pesta
- Charles University, Faculty of Medicine in Pilsen, Department of Biology, Pilsen, Czech Republic
| | - Jindra Windrichova
- Charles University, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Department of Immunochemistry Diagnostics, Pilsen, Czech Republic
| | - Petr Skopek
- Charles University, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Department of Otorhinolaryngology, Pilsen, Czech Republic
| | - Pavel Klail
- Charles University, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Department of Otorhinolaryngology, Pilsen, Czech Republic
| | - Alena Skalova
- Charles University, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Department of Pathology, Pilsen, Czech Republic
| | - Bretislav Gal
- Masaryk University, Faculty of Medicine, Department of Otorhinolaryngology and Head and Neck Surgery, Brno, Czech Republic
| | - Radek Kucera
- Charles University, Faculty of Medicine in Pilsen, Department of Pharmacology and Toxicology, Pilsen, Czech Republic
| | - Krista Plickova
- Charles University, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Department of Pneumology and Phthisiology, Pilsen, Czech Republic
| | - Vaclav Simanek
- Charles University, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Department of Otorhinolaryngology, Pilsen, Czech Republic
| | - David Slouka
- Charles University, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Department of Otorhinolaryngology, Pilsen, Czech Republic
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Hirani R, Smiley A. A Scoping Review of Sleep Apnea: Where Do We Stand? Life (Basel) 2023; 13:life13020387. [PMID: 36836743 PMCID: PMC9961756 DOI: 10.3390/life13020387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/11/2023] [Accepted: 01/28/2023] [Indexed: 02/01/2023] Open
Abstract
Obstructive sleep apnea (OSA), a condition in which there is a recurrent collapse of the upper airway while sleeping, is a widespread disease affecting 5% to 10% people worldwide. Despite several advances in the treatment modalities for OSA, morbidity and mortality remain a concern. Common symptoms include loud snoring, gasping for air during sleep, morning headache, insomnia, hypersomnia, attention deficits, and irritability. Obese individuals, male gender, older age (65+), family history, smoking, and alcohol consumption are well recognized risk factors of OSA. This condition holds the ability to increase inflammatory cytokines, cause metabolic dysfunction, and increase the sympathetic output, all of which exacerbate OSA due to their effect on the cardiovascular system. In this review, we discuss its brief history, risk factors, complications, treatment modalities, and the role of clinicians in curbing its risk.
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Affiliation(s)
- Rahim Hirani
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
- Department of Surgery, Westchester Medical Center, New York, NY 10595, USA
| | - Abbas Smiley
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
- Department of Surgery, Westchester Medical Center, New York, NY 10595, USA
- Correspondence:
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Yajima Y, Koyama T, Kobayashi M, Ichikawa T, Hoshino S, Abe H. Continuous Positive Airway Pressure Therapy Improves Heterogeneity of R-R intervals in a Patient with Obstructive Sleep Apnea Syndrome. Intern Med 2019; 58:1279-1282. [PMID: 30568134 PMCID: PMC6543230 DOI: 10.2169/internalmedicine.1837-18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Obstructive sleep apnea (OSA) is associated with the occurrence of various kinds of bradyarrhythmia and tachyarrhythmia. The activation of the autonomic nerve system is an important causative factor of the pathogenesis of the arrhythmia in OSA patients. Previous studies have shown that the R-R interval is an effective parameter for evaluating autonomic nerve activities. However, whether or not OSA can induce variations in the R-R interval and whether or not continuous positive airway pressure (CPAP) therapy can improve these variations in OSA patients are unclear. The present study explored whether or not CPAP therapy could improve the regularity of the R-R interval.
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Affiliation(s)
- Yoshiaki Yajima
- Department of Cardiovascular Surgery, Matsumoto Kyoritsu Hospital, Japan
| | - Takashi Koyama
- Department of Cardiovascular Medicine, Matsumoto Kyoritsu Hospital, Japan
| | - Masanori Kobayashi
- Department of Cardiovascular Medicine, Matsumoto Kyoritsu Hospital, Japan
| | - Tomohide Ichikawa
- Department of Cardiovascular Medicine, Matsumoto Kyoritsu Hospital, Japan
| | - Satoshi Hoshino
- Department of Cardiovascular Surgery, Matsumoto Kyoritsu Hospital, Japan
| | - Hidetoshi Abe
- Department of Cardiovascular Medicine, Matsumoto Kyoritsu Hospital, Japan
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Sozer V, Kutnu M, Atahan E, Calıskaner Ozturk B, Hysi E, Cabuk C, Musellim B, Simsek G, Uzun H. Changes in inflammatory mediators as a result of intermittent hypoxia in obstructive sleep apnea syndrome. CLINICAL RESPIRATORY JOURNAL 2017; 12:1615-1622. [PMID: 28960823 DOI: 10.1111/crj.12718] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 09/01/2017] [Accepted: 09/19/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Inflammation plays an important role in obstructive sleep apnea syndrome (OSAS). The objective of this study was to investigate the relationship of serum C-reactive protein (CRP), pentraxin-3 (PTX-3), procalcitonin (ProCT), interleukin-33 (IL-33) and its soluble receptor ST2 (sST2) with the syndrome severity and to show theirs importance as biomarkers. METHODS This study comprises a total of 84 identical (sex and age wise) cases. Full-night polysomnography was performed in each patient. OSAS diagnosis and severity index being based on the widely used criterion known as Apnea Hypopnea Index(AHI). Subgroups were as follows: 24(AHI < 5) controls, 28 mild-moderate OSAS(AHI 5-30) and 32 severe OSAS(AHI > 30). RESULTS PTX-3, IL-33 and sST2 receptors were significantly higher in OSAS groups than the control group (P < .001). However, both CRP and ProCT levels were similar in all subjects. There was a positive correlation between PTX-3 and BMI (r = 0.446; P < .01), ODI (r = 0.555; P < .01), IL-33 (r = 0.348; P = .001) and sST2 (r = 326; P = .002), while there was a negative correlation with minimum SaO2 (r = -0.672; P < .01) in patient group. PTX-3 as a predictor of OSAS showed highest specificity (%91.7) and sensitivity (%91.7) (P < .001). CONCLUSIONS PTX-3 can be a new indicator reflecting the inflammatory state in patients with OSAS. Since patients with OSAS could have more hypoxic state during sleep, we found higher PTX-3 level in those patients and a negative correlation between PTX-3 and minimum SaO2 , which could explain that PTX-3 levels can increase with the severity of disease. Our results suggest that PTX-3 as an inflammatory biomarker may play a crucial role as an indicator of syndrome severity in OSAS.
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Affiliation(s)
- Volkan Sozer
- Department of Biochemistry, Yildiz Technical University, Istanbul, Turkey
| | - Müge Kutnu
- Department of Biochemistry, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ersan Atahan
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Buket Calıskaner Ozturk
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ergi Hysi
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Cansu Cabuk
- Department of Biochemistry, Yildiz Technical University, Istanbul, Turkey
| | - Benan Musellim
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gonul Simsek
- Department of Physiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hafize Uzun
- Department of Biochemistry, Yildiz Technical University, Istanbul, Turkey
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Abstract
Obstructive sleep apnea (OSA) is a common disorder associated with cardiovascular disease (CVD). One theory to explain this relationship proposes that OSA can induce systemic inflammation, thereby inducing CVD. This theory is based on the premise that obesity is a pro-inflammatory state, and that physiological derangements during sleep in subjects with OSA further aggravate inflammation. In support of this theory, some clinical studies have shown elevated inflammatory biomarkers in OSA subjects, or improvement in these markers following treatment of OSA. However, the data are inconsistent and often confounded by the effects of comorbid obesity. Animal models of OSA have been developed, which involve exposure of rodents or cells to intermittent hypoxia, a hallmark feature of OSA. Several of these experiments demonstrate that intermittent hypoxia can stimulate inflammatory pathways and lead to cardiovascular or metabolic pathology. In this review, we review relationships between OSA and inflammation, with particular attention to studies published within the last year.
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Affiliation(s)
- Dileep Unnikrishnan
- Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Rm 5B.81, Baltimore, MD, 21224, USA
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