Continuous positive air pressure treatment reduces serum advanced glycation end products in patients with obstructive sleep apnoea syndrome: a pilot study

Association between serum level of advanced glycation end products and obstructive sleep apnea-hypopnea syndrome: a meta-analysis

Objective

This meta-analysis was performed to assess the difference in the serum level of advanced glycation end products (AGEs) between patients with obstructive sleep apnea–hypopnea syndrome (OSAHS) and controls.

Methods

A systematic literature search was performed using PubMed, Elsevier, SCI, Wanfang, Weipu, and China National Knowledge Internet. Eligible studies that reported the serum AGE level in patients with OSAHS were identified by two reviewers. Review Manager version 5.2 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark) and R version 3.10 (www.r-project.org) were employed for data synthesis.

Results

Five studies involving 670 subjects were identified. The meta-analysis showed that the mean serum AGE level in the OSAHS group was 0.98 mmol/L higher than those in the control group (95% confidence interval, 0.69–1.27).

Conclusions

This meta-analysis showed that the serum AGE level was elevated in patients with OSAHS. This finding suggests that AGEs may play an important role in insulin resistance in OSAHS and serve as a biomarker for patients with OSAHS with a high risk of type 2 diabetes mellitus.

Advanced Glycation End Products and Risks for Chronic Diseases: Intervening Through Lifestyle Modification

Advanced glycation end products (AGEs) are a family of compounds of diverse chemical nature that are the products of nonenzymatic reactions between reducing sugars and proteins, lipids, or nucleic acids. AGEs bind to one or more of their multiple receptors (RAGE) found on a variety of cell types and elicit an array of biologic responses. In this review, we have summarized the data on the nature of AGEs and issues associated with their measurements, their receptors, and changes in their expression under different physiologic and disease states. Last, we have used this information to prescribe lifestyle choices to modulate AGE-RAGE cycle for better health.

Sleep-disordered breathing is associated with higher carboxymethyllysine level in elderly women but not elderly men in the cardiovascular health study

CONTEXT

Carboxymethyl-lysine (CML) results from oxidative stress and has been linked to cardiovascular disease.

OBJECTIVE

The objective of this study is to investigate the association between sleep-disordered breathing (SDB) - a source of oxidative stress - and CML.

MATERIALS AND METHODS

About 1002 participants in the Cardiovascular Health Study (CHS) were studied.

RESULTS

Women with SDB had significantly higher CML concentration compared with those without SDB (OR = 1.63, 95%CI = 1.03-2.58, p = 0.04). The association was not significant among men.

DISCUSSION

SDB was associated with CML concentration among elderly women but not men in the Cardiovascular Health Study.

CONCLUSION

Accumulation of CML may be an adverse health consequence of SDB.

Relationship between serum levels of endogenous secretory RAGE and blood pressure in male nondiabetic patients with obstructive sleep apnea

The interaction of advanced glycation end products (AGE) and their specific cell-surface receptor (RAGE) has an important role in the pathogenesis of cardiovascular disease and diabetic complications. Two isoforms of C-truncated RAGE, soluble RAGE (sRAGE) and endogenous secretory RAGE (esRAGE), may prevent activation of RAGE signaling by acting as decoys. This study investigated whether serum esRAGE and sRAGE levels are associated with blood pressure in nondiabetic patients with obstructive sleep apnea (OSA). Male nondiabetic patients (n=139) with OSA were enrolled. Serum esRAGE and sRAGE levels were examined using enzyme-linked immunosorbent assay. Three consecutive seated systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements were obtained at 5-min intervals in the morning. In univariate analysis, there was a significant correlation between serum esRAGE and SBP or DBP, but not between serum sRAGE and SBP or DBP. Multiple regression analysis showed that SBP was independently associated with waist circumference, HbA1c, minimum SaO2 and serum esRAGE, and that DBP was independently associated with low-density lipoprotein cholesterol, apnea-hypopnea index, serum AGE and body mass index, but not with serum esRAGE. These results indicated that serum esRAGE levels were inversely associated with blood pressure, especially SBP, in male nondiabetic patients with OSA. esRAGE may have a protective role against hypertension in patients with OSA, and it may be a novel biomarker for OSA patients at high risk of developing cardiovascular diseases.