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Niranjan N, Sriram KB, Gopalan V. Obstructive Sleep Apnea and Colorectal Cancer: A Systematic Review and Meta-Analysis. J Gastrointest Cancer 2023; 54:1151-1157. [PMID: 36813984 DOI: 10.1007/s12029-023-00919-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Obstructive sleep apnea (OSA), characterised by recurrent episodes of upper airway collapse, intermittent hypoxia (IH) and sleep fragmentation (SF), has been associated with carcinogenesis in pre-clinical models. The relationship between OSA and colorectal cancer (CRC) in clinical studies is controversial. AIM The objective of this meta-analysis was to assess the association between OSA and CRC. METHODS Two independent investigators searched studies indexed in CINAHL, MEDLINE, EMBASE, the Cochrane Database and clinicaltrials.gov that were randomised controlled trials (RCT) or observational studies evaluating the relationship between OSA and CRC. Studies were included if they had available odds ratios (OR) and relative risks (RR) or if hazard ratios (HR) with 95% confidence intervals (CI) were available and a reference group composed of participants who did not have OSA. OR and 95% CI were calculated using a random-effect, generic inverse variance method. RESULTS We included four observational studies out of 85 records, comprising a combined cohort of 5,651,662 identified patients in the data analysis. Three studies used polysomnography to identify OSA. The pooled OR of CRC in patients with OSA was 1.49 (95% CI, 0.75 to 2.97). The statistical heterogeneity was high with I2 of 95%. CONCLUSIONS Our study is unable to conclusively point towards OSA being a risk factor in the development of CRC, despite the plausible biological mechanisms for this. Further well-designed prospective RCT assessing the risk of CRC in patients with OSA and the impact of OSA treatments on the incidence and prognosis of CRC are needed.
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Affiliation(s)
- Navin Niranjan
- Department of Respiratory Medicine, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD, 4215, Australia.
| | - Krishna Bajee Sriram
- Department of Respiratory Medicine, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD, 4215, Australia
- School of Medicine & Dentistry, Griffith University, Southport, Australia
| | - Vinod Gopalan
- School of Medicine & Dentistry, Griffith University, Southport, Australia
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Chiang PL, Hao WR, Hong HJ, Chen CC, Chiu CC, Fang YA, Yang TL, Lai YH, Chen MY, Hsu MH, Chiou KR, Lin KJ, Yang TY, Hsiu H, Liu JC. The Effects of Different Types of Sleep Disorder on Colorectal Cancer: A Nationwide Population-Based Cohort Study. Cancers (Basel) 2023; 15:4728. [PMID: 37835421 PMCID: PMC10571828 DOI: 10.3390/cancers15194728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
The impact of sleep disorders (SDs), particularly sleep apnea (SA), on the development of colorectal cancer (CRC) has been the subject of significant research. However, the potential contribution of other SDs to the incidence of CRC remains unexplored. The objective of this study was to examine the effects of SDs on the risk of developing CRC. This study assessed CRC risk among individuals diagnosed with SDs compared with age- and sex-matched unaffected individuals. A longitudinal, nationwide, population-based cohort study was conducted using data from the Taiwan National Health Insurance Research Database (NHIRD) encompassing 177,707 individuals diagnosed with SDs and 177,707 matched controls. Cox proportional hazard regression analysis was used to determine the relative increased risk of CRC in individuals with SDs and specific subgroups of SDs. The CRC incidences were 1.32-fold higher (95% CI 1.23-1.42) in the overall SD cohort, 1.17-fold higher (95% CI 0.82-1.68) in the SA cohort, 1.42-fold higher (95% CI 1.31-1.55) in the insomnia cohort, 1.27-fold higher (95% CI 1.17-1.38) in the sleep disturbance cohort, and 1.00-fold higher (95% CI 0.77-1.29) in the other SD cohort, after adjusting for age, sex, and comorbidities.
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Affiliation(s)
- Po-Lin Chiang
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan (T.-Y.Y.)
- Department of General Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Wen-Rui Hao
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan (T.-Y.Y.)
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan (K.-J.L.)
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Hong-Jye Hong
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung City 404333, Taiwan
| | - Chun-Chao Chen
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan (T.-Y.Y.)
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan (K.-J.L.)
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Chun-Chih Chiu
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan (T.-Y.Y.)
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan (K.-J.L.)
| | - Yu-Ann Fang
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan (T.-Y.Y.)
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan (K.-J.L.)
| | - Tsung-Lin Yang
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan (K.-J.L.)
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Division of Cardiology, Department of Internal Medicine and Cardiovascular Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Yu-Hsin Lai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (Y.-H.L.)
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Shuang Ho Hospital, New Taipei City 23561, Taiwan
| | - Ming-Yao Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; (Y.-H.L.)
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Shuang Ho Hospital, New Taipei City 23561, Taiwan
| | - Min-Huei Hsu
- Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei 11031, Taiwan
- Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Kuan-Rau Chiou
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan (T.-Y.Y.)
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan (K.-J.L.)
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Kuan-Jie Lin
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan (K.-J.L.)
- Division of Cardiovascular Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Tsung-Yeh Yang
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan (T.-Y.Y.)
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan (K.-J.L.)
| | - Hsin Hsiu
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, No. 43, Section 4, Keelung Road, Taipei 10607, Taiwan
| | - Ju-Chi Liu
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan (T.-Y.Y.)
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan (K.-J.L.)
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
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Yang T, He F, Zhang M, Ai L, He M, Liu X, Li Y. MiR-142-3p as an Indicator of OSA Severity Predicts Prognosis in Lung Adenocarcinoma with OSA. Nat Sci Sleep 2022; 14:2047-2054. [PMID: 36394065 PMCID: PMC9656355 DOI: 10.2147/nss.s385755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/25/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The aim was to explore the correlation between Obstructive sleep apnea (OSA) and Lung adenocarcinoma malignant prognosis and evaluate the miR-142-3p was used as an OSA severity indicator to predict the prognosis of Lung adenocarcinoma patients. METHODS This study comprised of 21 diagnosed lung adenocarcinoma patients with or without OSA. The sleep-related variables and tumor pathology were recorded. Hypoxia-inducible factor-1α (HIF1α) and ki67 expression were analyzed by immunohistochemistry in tumor samples. Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to assess the level of miR-142-3p. RESULTS Lung adenocarcinoma with OSA showed higher apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and the lower lowest pulse oxygen saturation (LSPO2) compared to Lung adenocarcinoma without OSA (P<0.05), and patients with severer OSA have an advanced TNM stage (P=0.004) and metastasis rate (p=0.032). In addition, OSA may down-regulate the miR-142-3p expression in patients with Lung adenocarcinoma, and the patients with low miR-142-3p expression exhibited severe OSA. MiR-142-3p levels significantly decreased in the advanced TNM stage (p=0.015), and the expression of miR-142-3p was negatively associated with AHI (r= -0.505, p=0.020), ODI (r= -0.513, p=0.017). CONCLUSION OSA severity may increase Lung adenocarcinoma malignant prognosis. OSA may down-regulate the expression of miR-42-3p. The expression of miR-142-3p was inversely correlated with AHI and ODI as a surrogate of OSA severity. Additionally, the low miR-142-3p expression level was significantly associated with advanced TNM stage in Lung adenocarcinoma patients.
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Affiliation(s)
- Ting Yang
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Fang He
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Mingxiang Zhang
- Department of Cardiothoracic Surgery, Children's Hospital affiliated to Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Li Ai
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Meng He
- Department of Thoracic Surgery, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Xin Liu
- Department of Thoracic Surgery, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
| | - Yongxia Li
- Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Yunnan, 650000, People's Republic of China
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