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Badran M, Puech C, Khalyfa A, Cortese R, Cataldo K, Qiao Z, Gozal D. Senolytic-facilitated Reversal of End-Organ Dysfunction in a Murine Model of Obstructive Sleep Apnea. Am J Respir Crit Care Med 2024; 209:1001-1012. [PMID: 38113165 DOI: 10.1164/rccm.202306-1101oc] [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: 06/26/2023] [Accepted: 12/19/2023] [Indexed: 12/21/2023] Open
Abstract
Rationale: Obstructive sleep apnea (OSA) is a highly prevalent condition that is associated with accelerated biological aging and multiple end-organ morbidities. Current treatments, such as continuous positive airway pressure (CPAP), have shown limited cognitive, metabolic, and cardiovascular beneficial outcomes despite adherence. Thus, adjunct therapies aiming to reduce OSA burden, such as senolytics, could improve OSA outcomes.Objectives: To assess if targeting senescence in addition to partial normoxia mimicking "good" CPAP adherence can improve physiological outcomes in mice exposed to chronic intermittent hypoxia.Methods: We compared the effects of 6 weeks of therapy with either partial normoxic recovery alone or combined with the senolytic navitoclax after 16 weeks of intermittent hypoxia exposures, a hallmark of OSA, on multiphenotypic cardiometabolic and neurocognitive parameters.Measurements and Main Results: Our findings indicate that only when combined with navitoclax, partial normoxic recovery significantly improved sleepiness (sleep in the dark phase: 34% ± 4% vs. 26% ± 3%; P < 0.01), cognition (preference score: 51% ± 19% vs. 70% ± 11%; P = 0.048), coronary artery function (response to acetylcholine [vasodilation]: 56% ± 13% vs. 72% ± 10%; P < 0.001), glucose, and lipid metabolism and reduced intestinal permeability and senescence in multiple organs.Conclusions: These findings indicate that the reversibility of end-organ morbidities induced by OSA is not only contingent on restoration of normal oxygenation patterns but can be further enhanced by targeting other OSA-mediated detrimental cellular processes, such as accelerated senescence.
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Affiliation(s)
- Mohammad Badran
- Department of Child Health and Child Health Research Institute, School of Medicine, University of Missouri, Columbia, Missouri; and
| | - Clementine Puech
- Department of Child Health and Child Health Research Institute, School of Medicine, University of Missouri, Columbia, Missouri; and
| | - Abdelnaby Khalyfa
- Department of Child Health and Child Health Research Institute, School of Medicine, University of Missouri, Columbia, Missouri; and
| | - Rene Cortese
- Department of Child Health and Child Health Research Institute, School of Medicine, University of Missouri, Columbia, Missouri; and
| | - Kylie Cataldo
- Department of Child Health and Child Health Research Institute, School of Medicine, University of Missouri, Columbia, Missouri; and
| | - Zhuanhong Qiao
- Department of Child Health and Child Health Research Institute, School of Medicine, University of Missouri, Columbia, Missouri; and
| | - David Gozal
- Department of Child Health and Child Health Research Institute, School of Medicine, University of Missouri, Columbia, Missouri; and
- Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
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2
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Nambiema A, Lisan Q, Vaucher J, Perier MC, Boutouyrie P, Danchin N, Thomas F, Guibout C, Solelhac G, Heinzer R, Jouven X, Marques-Vidal P, Empana JP. Healthy sleep score changes and incident cardiovascular disease in European prospective community-based cohorts. Eur Heart J 2023; 44:4968-4978. [PMID: 37860848 PMCID: PMC10719494 DOI: 10.1093/eurheartj/ehad657] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/20/2023] [Accepted: 07/25/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND AND AIMS Evidence on the link between sleep patterns and cardiovascular diseases (CVDs) in the community essentially relies on studies that investigated one single sleep pattern at one point in time. This study examined the joint effect of five sleep patterns at two time points with incident CVD events. METHODS By combining the data from two prospective studies, the Paris Prospective Study III (Paris, France) and the CoLaus|PsyCoLaus study (Lausanne, Switzerland), a healthy sleep score (HSS, range 0-5) combining five sleep patterns (early chronotype, sleep duration of 7-8 h/day, never/rarely insomnia, no sleep apnoea, and no excessive daytime sleepiness) was calculated at baseline and follow-up. RESULTS The study sample included 11 347 CVD-free participants aged 53-64 years (44.6% women). During a median follow-up of 8.9 years [interquartile range (IQR): 8.0-10.0], 499 first CVD events occurred (339 coronary heart disease (CHD) and 175 stroke). In multivariate Cox analysis, the risk of CVD decreased by 18% [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.76-0.89] per one-point increment in the HSS. After a median follow-up of 6.0 years (IQR: 4.0-8.0) after the second follow-up, 262 first CVD events occurred including 194 CHD and 72 stroke. After adjusting for baseline HSS and covariates, the risk of CVD decreased by 16% (HR 0.84, 95% CI 0.73-0.97) per unit higher in the follow-up HSS over 2-5 years. CONCLUSIONS Higher HSS and HSS improvement over time are associated with a lower risk of CHD and stroke in the community.
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Affiliation(s)
- Aboubakari Nambiema
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Quentin Lisan
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
- Department of Head and Neck Surgery, Foch Hospital, Suresnes, France
| | - Julien Vaucher
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Marie-Cecile Perier
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Pierre Boutouyrie
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Cellular, Molecular and Pathophysiological Mechanisms of Heart Failure, APHP, DMU CARTE, Pharmacology, Paris, France
| | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France
| | | | - Catherine Guibout
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Geoffroy Solelhac
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Raphael Heinzer
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Xavier Jouven
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Pedro Marques-Vidal
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
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3
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Stilo G, Vicini C, Pollicina I, Maniaci A, Lechien JR, Calvo-Henríquez C, Yáñez MM, Iannella G, Pace A, Cammaroto G, Meccariello G, Cannavicci A, Moffa A, Casale M, La Mantia I. Is Continuous Positive Airway Pressure a Valid Alternative to Sildenafil in Treating Sexual Dysfunction among OSA Patients? A Systematic Review and Meta-Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1318. [PMID: 37512129 PMCID: PMC10384051 DOI: 10.3390/medicina59071318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/26/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: This study aimed to assess the comparative effectiveness of continuous positive airway pressure (CPAP) therapy and sildenafil pharmacological therapy in improving sexual function among patients with obstructive sleep apnea (OSA) and erectile dysfunction (ED). Materials and methods: Population: Patients affected by OSA and ED; Intervention: CPAP therapy vs. Comparison: Sildenafil pharmacological therapy; Outcomes: Improvement in erectile function, as measured by the International Index of Erectile Function 5 (IIEF-5) scoring system; Time: A systematic review of the literature from the past 20 years; Study Design: Observational studies comparing erectile function improvements after OSA treatment. Results: A total of eight papers were included in the qualitative summary, involving four hundred fifty-seven patients with ED and OSA. Erectile function improvements were observed in both treatment groups. After sildenafil and CPAP treatment, the mean IIEF-5 domain scores were 37.7 and 27.3, respectively (p < 0.001). Sildenafil 100 mg demonstrated a higher therapeutic impact compared to CPAP treatment. Conclusions: CPAP therapy significantly improved sexual parameters in most studies for OSA patients with ED. The findings suggest that CPAP therapy effectively alleviates erectile dysfunction symptoms, resulting in improved sexual performance in OSA patients. The comparison of the two treatments indicates that sildenafil has a more substantial therapeutic impact on erectile function than CPAP therapy; however, a combined treatment will provide a cumulative effect.
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Affiliation(s)
- Giovanna Stilo
- Department of Medical and Surgical Sciences and Advance and Echnologies "GF Ingrassia", ENT Section, University of Catania, 95123 Catania, Italy
| | - Claudio Vicini
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy
| | - Isabella Pollicina
- Department of Medical and Surgical Sciences and Advance and Echnologies "GF Ingrassia", ENT Section, University of Catania, 95123 Catania, Italy
| | - Antonino Maniaci
- Department of Medical and Surgical Sciences and Advance and Echnologies "GF Ingrassia", ENT Section, University of Catania, 95123 Catania, Italy
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
| | - Jérôme René Lechien
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium
| | - Christian Calvo-Henríquez
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, 15701 Santiago de Compostela, Spain
| | - Miguel Mayo Yáñez
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Spain
| | - Giannicola Iannella
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
- Department of "Organi di Senso", University "Sapienza", 00185 Rome, Italy
| | - Annalisa Pace
- Department of "Organi di Senso", University "Sapienza", 00185 Rome, Italy
| | - Giovanni Cammaroto
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
| | - Giuseppe Meccariello
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy
| | - Angelo Cannavicci
- Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Head-Neck, Morgagni Pierantoni Hospital, 47121 Forli, Italy
- Research Committee Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 75000 Paris, France
| | - Antonio Moffa
- Unit of Otolaryngology, University Campus Bio-Medico, 00185 Rome, Italy
| | - Manuele Casale
- Unit of Otolaryngology, University Campus Bio-Medico, 00185 Rome, Italy
| | - Ignazio La Mantia
- Department of Medical and Surgical Sciences and Advance and Echnologies "GF Ingrassia", ENT Section, University of Catania, 95123 Catania, Italy
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4
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Chung ST, Krenek A, Magge SN. Childhood Obesity and Cardiovascular Disease Risk. Curr Atheroscler Rep 2023:10.1007/s11883-023-01111-4. [PMID: 37256483 DOI: 10.1007/s11883-023-01111-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE OF REVIEW The global epidemic of youth-onset obesity is tightly linked to the rising burden of cardiometabolic disease across the lifespan. While the link between childhood obesity and cardiovascular disease is established, this contemporary review summarizes recent and novel advances in this field that elucidate the mechanisms and impact of this public health issue. RECENT FINDINGS The review highlights the emerging data supporting the relationship between childhood adverse events, social determinants of health, and systemic and institutional systems as etiological factors. We also provide updates on new screening and treatment approaches including updated nutrition and dietary guidelines and benchmarks for pediatric obesity screening, novel pharmacological agents for pediatric obesity and type 2 diabetes such as glucagon-like 1 peptide receptor agonists, and we discuss the long-term safety and efficacy data on surgical management of pediatric obesity. The global burden of pediatric obesity continues to rise and is associated with accelerated and early vascular aging especially in youth with obesity and type 2 diabetes. Socio-ecological determinants of risk mediate and moderate the relationship of childhood obesity with cardiometabolic disease. Recognizing the importance of neighborhood level influences as etiological factors in the development of cardiovascular disease is critical for designing effective policies and interventions. Novel surgical and pharmacological interventions are effective pediatric weight-loss interventions, but future research is needed to assess whether these agents, within a socio-ecological framework, will be associated with abatement of the pediatric obesity epidemic and related increased cardiovascular disease risk.
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Affiliation(s)
- Stephanie T Chung
- Section on Pediatric Diabetes and Metabolism, National Institute of Diabetes & Digestive & Kidney Disease, NIH Bethesda, Bethesda, MD, USA
| | - Andrea Krenek
- Section on Pediatric Diabetes and Metabolism, National Institute of Diabetes & Digestive & Kidney Disease, NIH Bethesda, Bethesda, MD, USA
| | - Sheela N Magge
- Division of Pediatric Endocrinology and Diabetes, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Rubenstein Bldg, Rm 3114, Baltimore, MD, 21287, USA.
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5
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Su X, Li K, Yang L, Yang Y, Gao Y, Gao Y, Guo J, Lin J, Chen K, Han J, Liu L. Associations between abdominal obesity and the risk of stroke in Chinese older patients with obstructive sleep apnea: Is there an obesity paradox? Front Aging Neurosci 2022; 14:957396. [PMID: 36172486 PMCID: PMC9510899 DOI: 10.3389/fnagi.2022.957396] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background and purposeAbdominal obesity (AO) is a well-known independent risk factor for stroke in the general population although it remains unclear in the case of the elderly, especially in Chinese older patients with obstructive sleep apnea (OSA), considering the obesity paradox. This study aimed to investigate the association between AO and stroke among Chinese older patients with OSA.MethodsData were collected from January 2015 to October 2017, and 1,290 older patients (age 60–96 years) with OSA (apnea–hypopnea index ≥ 5 events/h on polysomnography) were consecutively enrolled from sleep centers at six hospitals, evaluated for AO defined as waist circumference (WC) using the standardized criteria for the Chinese population, and followed up prospectively for a median period of 42 months. Logistic regression and Cox regression analyses were used to determine the cross-sectional and longitudinal associations between AO and stroke risk in these participants and different groups of the severity of OSA.ResultsParticipants with AO had a higher prevalence of stroke at baseline. A higher incidence of stroke during a median follow-up period of 42 months in participants with AO than in participants without AO (12.4% vs. 6.8% and 8.3% vs. 2.4%, respectively; both P < 0.05) was predicted. Cross-sectional analysis revealed an association between AO and stroke (odds ratio [OR]1.96, 95% confidence interval [CI] 1.31–2.91), which was stronger among participants with moderate OSA only (OR 2.16, 95%CI 1.05–4.43). Cox regression analysis showed that, compared to participants without AO, participants with AO had a higher cumulative incidence of stroke (hazard ratio [HR] 2.16, 95% CI 1.12–4.04) during a median follow-up of 42 months, and this association was observed in patients with severe OSA only (HR 3.67, 95% CI 1.41–9.87) but not for individuals with mild OSA (HR = 1.84, 95% CI 0.43–6.23) and moderate OSA (HR = 1.98, 95% CI 0.73–6.45).ConclusionThe risk of stroke is associated with AO among Chinese older patients who have OSA, both at baseline and during follow-up, and the strength of the association varied by OSA severity. Active surveillance for early detection of AO could facilitate the implementation of stroke-preventive interventions in the Chinese older OSA population.
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Affiliation(s)
- Xiaofeng Su
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
- Sichuan College of Traditional Chinese Medicine, Mianyang, China
- Medical College, Yan’an University, Yan’an, China
| | - Kailiang Li
- Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Ling Yang
- Medical College, Yan’an University, Yan’an, China
| | - Yang Yang
- Medical College, Yan’an University, Yan’an, China
| | - Yinghui Gao
- PKU-UPenn Sleep Center, Peking University International Hospital, Beijing, China
| | - Yan Gao
- Department of General Practice, 960th Hospital of PLA, Jinan, China
| | - JingJing Guo
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Junling Lin
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Kaibing Chen
- Sleep Center, The Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
- *Correspondence: Lin Liu,
| | - Jiming Han
- Medical College, Yan’an University, Yan’an, China
- Jiming Han,
| | - Lin Liu
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
- Kaibing Chen,
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6
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Suzuki M, Shimamoto K, Tatsumi F, Tsuji T, Satoya N, Inoue Y, Hoshino T, Shiomi T, Hagiwara N. Long-term outcomes regarding arterial stiffness and carotid artery atherosclerosis in female patients with rapid eye movement obstructive sleep apnea. J Int Med Res 2022; 50:3000605221121941. [PMID: 36124891 PMCID: PMC9500274 DOI: 10.1177/03000605221121941] [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] [Indexed: 11/16/2022] Open
Abstract
Objective Rapid eye movement (REM) obstructive sleep apnea (OSA) is associated with the
risk of cardiovascular events. Arterial stiffness and carotid artery
intima-media thickness (IMT) predict these events, but few relevant studies
have been conducted. We compared long-term changes in arterial stiffness and
IMT between patients with REM OSA and non-REM (NREM) OSA receiving
continuous positive airway pressure (CPAP) or oral appliance (OA)
therapy. Methods Newly diagnosed female patients with OSA received CPAP (n = 6) or OA (n = 7).
Pulse wave velocity (PWV) and carotid artery ultrasound were performed
before and 60 months after treatment. Results There were no differences in baseline characteristics (mean age: 56.0 vs.
61.3 years; mean body mass index: 22.6 vs. 21.7 kg/m2) between
the REM OSA and non-REM OSA groups. The median apnea-hypopnea index was
lower in the REM OSA group than in the non-REM OSA group. Increased PWV
(12.92 ± 1.64 to 14.56 ± 2.73 m/s) and deteriorated glucose metabolism were
observed in the REM OSA group after treatment. PWV, IMT, and cardiovascular
risk factors were unaffected in the non-REM OSA group. Conclusion Arterial stiffness and glucose metabolism are deteriorated in patients with
REM OSA compared with these parameters in patients with non-REM OSA after
CPAP or OA treatment.
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Affiliation(s)
- Mayumi Suzuki
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University Hospital (TWMU), Tokyo, Japan
| | | | | | | | | | - Yuji Inoue
- Central Clinical Laboratory, TWMU, Tokyo, Japan
| | - Tetsuro Hoshino
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Hoshino ENT and Sleep Disordered Breathing Center, Hyogo, Japan
| | - Toshiaki Shiomi
- Department of Sleep Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuhisa Hagiwara
- Division of Comprehensive Sleep Medicine, Tokyo Women's Medical University Hospital (TWMU), Tokyo, Japan.,Department of Cardiology, TWMU, Tokyo, Japan
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7
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Cederberg KLJ, Hanif U, Peris Sempere V, Hédou J, Leary EB, Schneider LD, Lin L, Zhang J, Morse AM, Blackman A, Schweitzer PK, Kotagal S, Bogan R, Kushida CA, Ju YES, Petousi N, Turnbull CD, Mignot E. Proteomic Biomarkers of the Apnea Hypopnea Index and Obstructive Sleep Apnea: Insights into the Pathophysiology of Presence, Severity, and Treatment Response. Int J Mol Sci 2022; 23:7983. [PMID: 35887329 PMCID: PMC9317550 DOI: 10.3390/ijms23147983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/11/2022] [Accepted: 07/17/2022] [Indexed: 11/16/2022] Open
Abstract
Obstructive sleep apnea (OSA), a disease associated with excessive sleepiness and increased cardiovascular risk, affects an estimated 1 billion people worldwide. The present study examined proteomic biomarkers indicative of presence, severity, and treatment response in OSA. Participants (n = 1391) of the Stanford Technology Analytics and Genomics in Sleep study had blood collected and completed an overnight polysomnography for scoring the apnea−hypopnea index (AHI). A highly multiplexed aptamer-based array (SomaScan) was used to quantify 5000 proteins in all plasma samples. Two separate intervention-based cohorts with sleep apnea (n = 41) provided samples pre- and post-continuous/positive airway pressure (CPAP/PAP). Multivariate analyses identified 84 proteins (47 positively, 37 negatively) associated with AHI after correction for multiple testing. Of the top 15 features from a machine learning classifier for AHI ≥ 15 vs. AHI < 15 (Area Under the Curve (AUC) = 0.74), 8 were significant markers of both AHI and OSA from multivariate analyses. Exploration of pre- and post-intervention analysis identified 5 of the 84 proteins to be significantly decreased following CPAP/PAP treatment, with pathways involving endothelial function, blood coagulation, and inflammatory response. The present study identified PAI-1, tPA, and sE-Selectin as key biomarkers and suggests that endothelial dysfunction and increased coagulopathy are important consequences of OSA, which may explain the association with cardiovascular disease and stroke.
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Affiliation(s)
- Katie L. J. Cederberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, 3165 Porter Drive, Stanford, CA 94304, USA; (K.L.J.C.); (U.H.); (V.P.S.); (J.H.); (E.B.L.); (L.D.S.); (L.L.); (J.Z.); (C.A.K.)
| | - Umaer Hanif
- Department of Psychiatry and Behavioral Sciences, Stanford University, 3165 Porter Drive, Stanford, CA 94304, USA; (K.L.J.C.); (U.H.); (V.P.S.); (J.H.); (E.B.L.); (L.D.S.); (L.L.); (J.Z.); (C.A.K.)
- Biomedical Signal Processing & AI Research Group, Department of Health Technology, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, 2600 Glostrup, Denmark
| | - Vicente Peris Sempere
- Department of Psychiatry and Behavioral Sciences, Stanford University, 3165 Porter Drive, Stanford, CA 94304, USA; (K.L.J.C.); (U.H.); (V.P.S.); (J.H.); (E.B.L.); (L.D.S.); (L.L.); (J.Z.); (C.A.K.)
| | - Julien Hédou
- Department of Psychiatry and Behavioral Sciences, Stanford University, 3165 Porter Drive, Stanford, CA 94304, USA; (K.L.J.C.); (U.H.); (V.P.S.); (J.H.); (E.B.L.); (L.D.S.); (L.L.); (J.Z.); (C.A.K.)
| | - Eileen B. Leary
- Department of Psychiatry and Behavioral Sciences, Stanford University, 3165 Porter Drive, Stanford, CA 94304, USA; (K.L.J.C.); (U.H.); (V.P.S.); (J.H.); (E.B.L.); (L.D.S.); (L.L.); (J.Z.); (C.A.K.)
- Jazz Pharmaceuticals, 3170 Porter Drive, Palo Alto, CA 94304, USA
| | - Logan D. Schneider
- Department of Psychiatry and Behavioral Sciences, Stanford University, 3165 Porter Drive, Stanford, CA 94304, USA; (K.L.J.C.); (U.H.); (V.P.S.); (J.H.); (E.B.L.); (L.D.S.); (L.L.); (J.Z.); (C.A.K.)
- Alphabet, Inc., 1600 Amphitheater Parkway Mountain View, Palo Alto, CA 94043, USA
- Stanford/VA Alzheimer’s Research Center, 3801 Miranda Ave, Building 4, C-141, Mail Code 116F-PAD, Palo Alto, CA 94304, USA
| | - Ling Lin
- Department of Psychiatry and Behavioral Sciences, Stanford University, 3165 Porter Drive, Stanford, CA 94304, USA; (K.L.J.C.); (U.H.); (V.P.S.); (J.H.); (E.B.L.); (L.D.S.); (L.L.); (J.Z.); (C.A.K.)
| | - Jing Zhang
- Department of Psychiatry and Behavioral Sciences, Stanford University, 3165 Porter Drive, Stanford, CA 94304, USA; (K.L.J.C.); (U.H.); (V.P.S.); (J.H.); (E.B.L.); (L.D.S.); (L.L.); (J.Z.); (C.A.K.)
| | - Anne M. Morse
- Division of Child Neurology and Pediatric Sleep Medicine, Geisinger, Janet Weis Children’s Hospital, 100 N Academy Ave, Danville, PA 17822, USA;
| | - Adam Blackman
- Department of Psychiatry, University of Toronto, Toronto, ON M5G 1L5, Canada;
| | - Paula K. Schweitzer
- Sleep Medicine & Research Center, St. Lukes Hospital, 232 S. Woods Mill Road, Chesterfield, MO 63017, USA;
| | - Suresh Kotagal
- Department of Neurology, Mayo Clinic, 200 First St., Rochester, MN 55905, USA;
| | - Richard Bogan
- College of Medicine, Medical University of South Carolina, 171 Ashley Ave, Charleston, SC 29425, USA;
| | - Clete A. Kushida
- Department of Psychiatry and Behavioral Sciences, Stanford University, 3165 Porter Drive, Stanford, CA 94304, USA; (K.L.J.C.); (U.H.); (V.P.S.); (J.H.); (E.B.L.); (L.D.S.); (L.L.); (J.Z.); (C.A.K.)
| | - Yo-El S. Ju
- Department of Neurology, Washington University, St. Louis, MO 63110, USA;
- Hope Center for Neurological Disorders, Washington University, St. Louis, MO 63110, USA
- Center on Biological Rhythms and Sleep (COBRAS), Washington University, 1600 S. Brentwood Blvd, St. Louis, MO 63144, USA
| | - Nayia Petousi
- Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Headley Way, Headington, Oxford OX3 9DU, UK;
- National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Headley Way, Headington, Oxford OX3 9DU, UK;
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford OX3 9DU, UK
| | - Chris D. Turnbull
- National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Headley Way, Headington, Oxford OX3 9DU, UK;
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford OX3 9DU, UK
| | - Emmanuel Mignot
- Department of Psychiatry and Behavioral Sciences, Stanford University, 3165 Porter Drive, Stanford, CA 94304, USA; (K.L.J.C.); (U.H.); (V.P.S.); (J.H.); (E.B.L.); (L.D.S.); (L.L.); (J.Z.); (C.A.K.)
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8
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Veugen MGJ, Onete VG, Henry RMA, Brunner-La Rocca HP, Koster A, Dagnelie PC, Schaper NC, Sep SJS, van der Kallen CJH, van Boxtel MPJ, Reesink KD, Schouten JS, Savelberg HHCM, Köhler S, Verhey FR, van den Bergh JPW, Schram MT, Stehouwer CDA. Health burden in type 2 diabetes and prediabetes in The Maastricht Study. Sci Rep 2022; 12:7337. [PMID: 35513556 PMCID: PMC9072328 DOI: 10.1038/s41598-022-11136-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 04/19/2022] [Indexed: 12/02/2022] Open
Abstract
Mortality in type 2 diabetes, is determined not only by classical complications, but also by comorbidities, and is linked to hyperglycaemia and apparent even in prediabetes. We aimed to comprehensively investigate, in a population-based cohort, health burden defined as the presence of comorbidities in addition to classical complications and cardiometabolic risk factors, in not only type 2 diabetes but also prediabetes. Such population-based study has not been performed previously. Extensive phenotyping was performed in 3,410 participants of the population-based Maastricht Study (15.0% prediabetes and 28.6% type 2 diabetes) to assess presence of 17 comorbidities, six classical complications, and ten cardiometabolic risk factors. These were added up into individual and combined sum scores and categorized. Group differences were studied with multinomial regression analyses adjusted for age and sex. Individuals with type 2 diabetes and prediabetes, as compared to normal glucose metabolism (NGM), had greater comorbidities, classical complications, cardiometabolic risk factors and combined sum scores (comorbidities sum score ≥ 3: frequencies (95% CI) 61.5% (57.6;65.4) and 41.2% (36.5;45.9) vs. 25.4% (23.5;27.4), p-trend < 0.001; classical complications ≥ 2 (26.6% (23.1;30.1; P < 0.001 vs. NGM) and 10.1% (7.8;12.7; P = 0.065 vs NGM) vs. 8.0% (6.9;9.3)); cardiometabolic risk factors ≥ 6 (39.7% (35.9;43.4) and 28.5% (24.5;32.6) vs. 14.0% (12.5;15.6); p-trend < 0.001); combined ≥ 8 (66.6% (62.7;70.5) and 48.4% (43.7;53.1) vs. 26.0%(24.1;28.0), p-trend < 0.001). Type 2 diabetes and prediabetes health burden was comparable to respectively 32 and 14 years of ageing. Our population-based study shows, independently of age and sex, a considerable health burden in both type 2 diabetes and prediabetes, which to a substantial extent can be attributed to comorbidities in addition to classical complications and cardiometabolic risk factors. Our findings emphasize the necessity of comorbidities' awareness in (pre)diabetes and for determining the exact role of hyperglycaemia in the occurrence of comorbidities.
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Affiliation(s)
- Marja G J Veugen
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands.
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
| | - Veronica G Onete
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Ronald M A Henry
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre +, Maastricht, The Netherlands
| | - Hans-Peter Brunner-La Rocca
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Department of Cardiology, Maastricht University Medical Centre +, Maastricht, the Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Nicolaas C Schaper
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Simone J S Sep
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Martin P J van Boxtel
- Department of Psychiatry and Neuropsychology and MHeNS School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Koen D Reesink
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Department of Biomedical Engineering, Maastricht University Medical Centre +, Maastricht, The Netherlands
| | - Johannes S Schouten
- Department of Ophthalmology, Maastricht University Medical Centre +, Maastricht, The Netherlands
- Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Hans H C M Savelberg
- Department of Human Movement Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology and MHeNS School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Frans R Verhey
- Department of Psychiatry and Neuropsychology and MHeNS School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Joop P W van den Bergh
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Internal Medicine, Subdivision of Endocrinology, VieCuri Medical Center, Venlo, The Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre +, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre +, P. Debyelaan 25, P.O. Box 5800, 6202AZ, Maastricht, The Netherlands.
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
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9
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Camañes-Gonzalvo S, Bellot-Arcís C, Marco-Pitarch R, Montiel-Company JM, García-Selva M, Agustín-Panadero R, Paredes-Gallardo V, Puertas-Cuesta FJ. Comparison of the phenotypic characteristics between responders and non-responders to obstructive sleep apnea treatment using mandibular advancement devices in adult patients: systematic review and meta-analysis. Sleep Med Rev 2022; 64:101644. [DOI: 10.1016/j.smrv.2022.101644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 12/28/2022]
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