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Lavalle S, Masiello E, Iannella G, Magliulo G, Pace A, Lechien JR, Calvo-Henriquez C, Cocuzza S, Parisi FM, Favier V, Bahgat AY, Cammaroto G, La Via L, Gagliano C, Caranti A, Vicini C, Maniaci A. Unraveling the Complexities of Oxidative Stress and Inflammation Biomarkers in Obstructive Sleep Apnea Syndrome: A Comprehensive Review. Life (Basel) 2024; 14:425. [PMID: 38672697 PMCID: PMC11050908 DOI: 10.3390/life14040425] [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: 02/02/2024] [Revised: 03/03/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Obstructive sleep apnea syndrome (OSAS), affecting approximately 1 billion adults globally, is characterized by recurrent airway obstruction during sleep, leading to oxygen desaturation, elevated carbon dioxide levels, and disrupted sleep architecture. OSAS significantly impacts quality of life and is associated with increased morbidity and mortality, particularly in the cardiovascular and cognitive domains. The cyclic pattern of intermittent hypoxia in OSAS triggers oxidative stress, contributing to cellular damage. This review explores the intricate relationship between OSAS and oxidative stress, shedding light on molecular mechanisms and potential therapeutic interventions. METHODS A comprehensive review spanning from 2000 to 2023 was conducted using the PubMed, Cochrane, and EMBASE databases. Inclusion criteria encompassed English articles focusing on adults or animals and reporting values for oxidative stress and inflammation biomarkers. RESULTS The review delineates the imbalance between pro-inflammatory and anti-inflammatory factors in OSAS, leading to heightened oxidative stress. Reactive oxygen species biomarkers, nitric oxide, inflammatory cytokines, endothelial dysfunction, and antioxidant defense mechanisms are explored in the context of OSAS. OSAS-related complications include cardiovascular disorders, neurological impairments, metabolic dysfunction, and a potential link to cancer. This review emphasizes the potential of antioxidant therapy as a complementary treatment strategy. CONCLUSIONS Understanding the molecular intricacies of oxidative stress in OSAS is crucial for developing targeted therapeutic interventions. The comprehensive analysis of biomarkers provides insights into the complex interplay between OSAS and systemic complications, offering avenues for future research and therapeutic advancements in this multifaceted sleep disorder.
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Affiliation(s)
- Salvatore Lavalle
- Faculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (C.G.)
| | - Edoardo Masiello
- Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy;
| | - Giannicola Iannella
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.I.); (G.M.); (A.P.)
| | - Giuseppe Magliulo
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.I.); (G.M.); (A.P.)
| | - Annalisa Pace
- Department of ‘Organi di Senso’, University “Sapienza”, Viale dell’Università, 33, 00185 Rome, Italy; (G.I.); (G.M.); (A.P.)
| | - Jerome Rene Lechien
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, 7022 Mons, Belgium;
| | - Christian Calvo-Henriquez
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, 15705 Santiago de Compostela, Spain;
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy; (S.C.); (F.M.P.)
| | - Federica Maria Parisi
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy; (S.C.); (F.M.P.)
| | - Valentin Favier
- Service d’ORL et de Chirurgie Cervico-Faciale, Centre Hospitalo-Universitaire de Montpellier, 80 Avenue Augustin Fliche, 34000 Montpellier, France
| | - Ahmed Yassin Bahgat
- Department of Otorhinolaryngology, Alexandria University, Alexandria 21577, Egypt;
| | - Giovanni Cammaroto
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy;
| | - Luigi La Via
- Department of Anaesthesia and Intensive Care, University Hospital Policlinico-San Marco, 95125 Catania, Italy;
| | - Caterina Gagliano
- Faculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (C.G.)
| | - Alberto Caranti
- ENT and Audiology Department, University of Ferrara, 44121 Ferrara, Italy; (A.C.); (C.V.)
| | - Claudio Vicini
- ENT and Audiology Department, University of Ferrara, 44121 Ferrara, Italy; (A.C.); (C.V.)
| | - Antonino Maniaci
- Faculty of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (C.G.)
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Alterki A, Abu-Farha M, Al Shawaf E, Al-Mulla F, Abubaker J. Investigating the Relationship between Obstructive Sleep Apnoea, Inflammation and Cardio-Metabolic Diseases. Int J Mol Sci 2023; 24:ijms24076807. [PMID: 37047780 PMCID: PMC10095553 DOI: 10.3390/ijms24076807] [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: 02/08/2023] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
Obstructive sleep apnoea (OSA) is a prevalent underdiagnosed disorder whose incidence increases with age and weight. Uniquely characterised by frequent breathing interruptions during sleep-known as intermittent hypoxia (IH)-OSA disrupts the circadian rhythm. Patients with OSA have repeated episodes of hypoxia and reoxygenation, leading to systemic consequences. OSA consequences range from apparent symptoms like excessive daytime sleepiness, neurocognitive deterioration and decreased quality of life to pathological complications characterised by elevated biomarkers linked to endocrine-metabolic and cardiovascular changes. OSA is a well-recognized risk factor for cardiovascular and cerebrovascular diseases. Furthermore, OSA is linked to other conditions that worsen cardiovascular outcomes, such as obesity. The relationship between OSA and obesity is complex and reciprocal, involving interaction between biological and lifestyle factors. The pathogenesis of both OSA and obesity involve oxidative stress, inflammation and metabolic dysregulation. The current medical practice uses continuous positive airway pressure (CPAP) as the gold standard tool to manage OSA. It has been shown to improve symptoms and cardiac function, reduce cardiovascular risk and normalise biomarkers. Nonetheless, a full understanding of the factors involved in the deleterious effects of OSA and the best methods to eliminate their occurrence are still poorly understood. In this review, we present the factors and evidence linking OSA to increased risk of cardiovascular conditions.
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Affiliation(s)
- Abdulmohsen Alterki
- Department of Otolaryngology Head & Neck Surgery, Zain and Al Sabah Hospitals and Dasman Diabetes Institute, Dasman 15462, Kuwait
| | - Mohamed Abu-Farha
- Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Dasman 15462, Kuwait
| | - Eman Al Shawaf
- Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Dasman 15462, Kuwait
| | - Fahd Al-Mulla
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman 15462, Kuwait
| | - Jehad Abubaker
- Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Dasman 15462, Kuwait
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Molecular Pathology, Oxidative Stress, and Biomarkers in Obstructive Sleep Apnea. Int J Mol Sci 2023; 24:ijms24065478. [PMID: 36982552 PMCID: PMC10058074 DOI: 10.3390/ijms24065478] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is characterized by intermittent hypoxia (IH) during sleep due to recurrent upper airway obstruction. The derived oxidative stress (OS) leads to complications that do not only concern the sleep-wake rhythm but also systemic dysfunctions. The aim of this narrative literature review is to investigate molecular alterations, diagnostic markers, and potential medical therapies for OSAS. We analyzed the literature and synthesized the evidence collected. IH increases oxygen free radicals (ROS) and reduces antioxidant capacities. OS and metabolic alterations lead OSAS patients to undergo endothelial dysfunction, osteoporosis, systemic inflammation, increased cardiovascular risk, pulmonary remodeling, and neurological alterations. We treated molecular alterations known to date as useful for understanding the pathogenetic mechanisms and for their potential application as diagnostic markers. The most promising pharmacological therapies are those based on N-acetylcysteine (NAC), Vitamin C, Leptin, Dronabinol, or Atomoxetine + Oxybutynin, but all require further experimentation. CPAP remains the approved therapy capable of reversing most of the known molecular alterations; future drugs may be useful in treating the remaining dysfunctions.
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Campos AI, Ingold N, Huang Y, Mitchell BL, Kho PF, Han X, García-Marín LM, Ong JS, Law MH, Yokoyama JS, Martin NG, Dong X, Cuellar-Partida G, MacGregor S, Aslibekyan S, Rentería ME. Discovery of genomic loci associated with sleep apnea risk through multi-trait GWAS analysis with snoring. Sleep 2023; 46:6918774. [PMID: 36525587 PMCID: PMC9995783 DOI: 10.1093/sleep/zsac308] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 11/11/2022] [Indexed: 12/23/2022] Open
Abstract
STUDY OBJECTIVES Despite its association with severe health conditions, the etiology of sleep apnea (SA) remains understudied. This study sought to identify genetic variants robustly associated with SA risk. METHODS We performed a genome-wide association study (GWAS) meta-analysis of SA across five cohorts (NTotal = 523 366), followed by a multi-trait analysis of GWAS (multi-trait analysis of genome-wide association summary statistics [MTAG]) to boost power, leveraging the high genetic correlation between SA and snoring. We then adjusted our results for the genetic effects of body mass index (BMI) using multi-trait-based conditional and joint analysis (mtCOJO) and sought replication of lead hits in a large cohort of participants from 23andMe, Inc (NTotal = 1 477 352; Ncases = 175 522). We also explored genetic correlations with other complex traits and performed a phenome-wide screen for causally associated phenotypes using the latent causal variable method. RESULTS Our SA meta-analysis identified five independent variants with evidence of association beyond genome-wide significance. After adjustment for BMI, only one genome-wide significant variant was identified. MTAG analyses uncovered 49 significant independent loci associated with SA risk. Twenty-nine variants were replicated in the 23andMe GWAS adjusting for BMI. We observed genetic correlations with several complex traits, including multisite chronic pain, diabetes, eye disorders, high blood pressure, osteoarthritis, chronic obstructive pulmonary disease, and BMI-associated conditions. CONCLUSION Our study uncovered multiple genetic loci associated with SA risk, thus increasing our understanding of the etiology of this condition and its relationship with other complex traits.
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Affiliation(s)
- Adrian I Campos
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.,Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - Nathan Ingold
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Brittany L Mitchell
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Pik-Fang Kho
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Xikun Han
- Program in Genetic Epidemiology and Statistical Genetics, Harvard University T.H. Chan School of Public Health, Boston, MA, USA
| | - Luis M García-Marín
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Jue-Sheng Ong
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | | | - Matthew H Law
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jennifer S Yokoyama
- Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA.,Weill Institute of Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | | | - Xianjun Dong
- Genomics and Bioinformatics Hub, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | | | - Miguel E Rentería
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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Adeleke I, Kersh JS, Sweitzer B. Perioperative management and optimization of atrial fibrillation for noncardiac surgery. Int Anesthesiol Clin 2022; 60:16-23. [PMID: 34897218 DOI: 10.1097/aia.0000000000000352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Ibukun Adeleke
- Department of Anesthesiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jay S Kersh
- Department of Anesthesiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Huang W, Li H, Li H, Huang T, Yuan S, Lü T. White matter lesions are associated with obstructive sleep apnea hypopnea syndrome. Neurol Res 2021; 44:423-428. [PMID: 34781838 DOI: 10.1080/01616412.2021.2000823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Study on the association of white matter lesions with obstructive sleep apnea hypopnea syndrome and its risk factors. METHODS A recruited study with a sample of 172 patients from the department of neurology of the Third Affiliated Hospital of Southern Medical University between 2015 and 2019. RESULTS According to the univariate analysis, the independent variables where P < 0.1 were included in the multivariate logistic regression model. After adjusting for confounding factors, the two-category logistic regression showed that Obstructive sleep apnea hypopnea syndrome (OSAHS) (OR = 8.347, 95%CI: 2.561 ~ 27.212, P < 0.001) were independent risk factors for WML, and that the prevalence of Cerebral white matter lesions (WML) increased with the severity of OSAHS (P = 0.002). In the non-OSAHS group, the mild OSAHS group, and the moderate-to-severe OSAHS group the apnea-hypopnea index (AHI) in the supine position was significantly higher than that in the left or right lateral position, showing a decreasing trend. The SaO2 < 90% total sleep time (TST SaO2 < 90%) showed an increasing trend, as did the body mass index. In the OSAHS severity groups, the AHI in the supine position was significantly higher than that in the left or right lateral position. Spearman correlation analysis showed that WML was positively related to AHI in the supine position (r = 0.209, P = 0.006). CONCLUSIONS OSAHS was an independent risk factor for WML. There was a positive relationship between WML and AHI in the supine position. ABBREVIATIONS AHI, apnea-hypopnea index; OSAHS, obstructive sleep apnea hypopnea syndrome; WML, white matter lesions; MRI, magnetic resonance imaging; BMI, body mass index; TSTSaO2 <90%, SaO2 <90% total sleep time; LSaO2, lowest oxygen saturation level; CI, confidence interval; OR, odds ratio.
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Affiliation(s)
- Weihua Huang
- Department of Respiration Medicine, The Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Huanmin Li
- Department of Neurology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, PR China
| | - Huan Li
- Department of Neurology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, PR China
| | - Tianrong Huang
- Department of Neurology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, PR China
| | - Shiqi Yuan
- Department of Neurology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, PR China
| | - Tianming Lü
- Department of Neurology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, PR China
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Oxidative Stress Markers among Obstructive Sleep Apnea Patients. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:9681595. [PMID: 34336121 PMCID: PMC8321764 DOI: 10.1155/2021/9681595] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/30/2021] [Accepted: 07/07/2021] [Indexed: 12/24/2022]
Abstract
Obstructive sleep apnea (OSA) is a chronic respiratory disorder, which can be present in up to 50% of the population, depending on the country. OSA is characterized by recurrent episodes of partial or complete obstruction of the upper airways with consistent movement of the respiratory musculature during sleep. Apneas and hypopneas can lead to a decrease in oxygen saturation, an increase in carbon dioxide in the blood, and subsequent arousals and sleep fragmentation caused by repetitive activation of the central nervous system. As a consequence, intermittent hypoxemia and consequent reoxygenation result in the production of reactive oxygen species, leading to systematic oxidative stress, which is postulated to be a key mechanism of endothelial dysfunction and increased risk for cardiovascular disorders in patients with OSA. In this review, various biomarkers of oxidative stress, including high-sensitivity C-reactive protein, pregnancy-associated plasma protein-A, superoxide dismutase, cell-free DNA, 8-hydroxy-2-deoxyguanosine, advanced oxidation protein products, lipid peroxidation products, receptor for advanced glycation end-products, and thioredoxin are discussed. Biomarkers of oxidative stress have the potential to be used to assess disease severity and treatment response. Continuous positive airway pressure (CPAP) is one of the most common noninvasive treatments for OSA; it keeps the upper airways open during sleep. This reduces episodes of intermittent hypoxia, reoxygenation, and arousal at night. CPAP has been shown to have anti-inflammatory properties and decrease oxidative stress. The administration of certain compounds, like vitamins A, C, and E as well as N-acetylcysteine and allopurinol, can decrease oxidative stress markers. However, their role in the treatment of OSA remains unclear.
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Oxidative Stress and Inflammation Biomarker Expression in Obstructive Sleep Apnea Patients. J Clin Med 2021; 10:jcm10020277. [PMID: 33451164 PMCID: PMC7828672 DOI: 10.3390/jcm10020277] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 02/08/2023] Open
Abstract
Obstructive Sleep Apnea Syndrome (OSAS) is a respiratory sleep disorder characterised by repeated episodes of partial or complete obstruction of the upper airway during the night. This obstruction usually occurs with a reduction (hypopnea) or complete cessation (apnea) of the airflow in the upper airways with the persistence of thoracic-diaphragmatic respiratory movements. During the hypopnea/apnea events, poor alveolar ventilation reduces the oxygen saturation in the arterial blood (SaO2) and a gradual increase in the partial arterial pressure of carbon dioxide (PaCO2). The direct consequence of the intermittent hypoxia is an oxidative imbalance, with reactive oxygen species production and the inflammatory cascade’s activation with pro and anti-inflammatory cytokines growth. Tumour necrosis factors, inflammatory cytokines (IL2, IL4, IL6), lipid peroxidation, and cell-free DNA have been found to increase in OSAS patients. However, even though different risk-related markers have been described and analysed in the literature, it has not yet been clarified whether specified inflammatory bio-markers better correlates with OSAS diagnosis and its clinical evolution/comorbidities. We perform a scientific literature review to discuss inflammatory and oxidative stress biomarkers currently tested in OSAS patients and their correlation with the disease’s severity and treatment.
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The Role of Vitamin C in Two Distinct Physiological States: Physical Activity and Sleep. Nutrients 2020; 12:nu12123908. [PMID: 33371359 PMCID: PMC7767325 DOI: 10.3390/nu12123908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/11/2020] [Accepted: 12/16/2020] [Indexed: 12/26/2022] Open
Abstract
This paper is a literature overview of the complex relationship between vitamin C and two opposing physiological states, physical activity and sleep. The evidence suggests a clinically important bidirectional association between these two phenomena mediated by different physiological mechanisms. With this in mind, and knowing that both states share a connection with oxidative stress, we discuss the existing body of evidence to answer the question of whether vitamin C supplementation can be beneficial in the context of sleep health and key aspects of physical activity, such as performance, metabolic changes, and antioxidant function. We analyze the effect of ascorbic acid on the main sleep components, sleep duration and quality, focusing on the most common disorders: insomnia, obstructive sleep apnea, and restless legs syndrome. Deeper understanding of those interactions has implications for both public health and clinical practice.
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Transferrin saturation is independently associated with the severity of obstructive sleep apnea syndrome and hypoxia among obese subjects. Clin Nutr 2020; 40:608-614. [PMID: 32600855 DOI: 10.1016/j.clnu.2020.06.007] [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: 05/24/2019] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION & AIMS Obstructive sleep apnea syndrome (OSAS) is a frequent complication of obesity. Intermittent chronic hypoxia which frequently results from OSAS could modulate the systemic control of iron metabolism and alter serum iron parameters, especially among obese patients. AIMS to evaluate whether serum parameters of iron bioavailability and storage (primary), as well as age, waist circumference, arterial hypertension and tobacco use (secondary) are associated with OSAS severity and/or hypoxia. METHODS design: a single-center retrospective study with prospective data collection; inclusion criteria: consecutive patients referred for initial assessment for obesity underwent nocturnal respiratory polygraphy and iron status serum assessment within a 3-month period. The adjusted analyzes were performed using ANOVA and reported as adjusted means and 95% confidence interval (95% CI). RESULTS 13 men and 56 women were included. OSAS prevalence: 72% (n = 50). Ferritin (mean ± SD, 260 ± 276 vs. 111 ± 89 μg/l, p = 0.01) and transferrin saturation (31 ± 10 vs. 24 ± 9%, p = 0.002) were significantly higher in case of moderate/severe OSAS than in absent/mild OSAS, independently from gender and tobacco use. Serum iron (19.4 μg/l [CI95%, 16.5-22.3] vs. 16.2 μg/l ([14.1-18.2], p = 0.056) and transferrin saturation (31.5% [26.3-36.7]) vs. 25.3% [21.6-29.1], p = 0.043) were higher when time under oxygen saturation <90% was >15%. Age (mean ± SD, 51 ± 11 vs. 41 ± 12 yr, p = 0.001), waist circumference (136 ± 18 vs. 123 ± 12 cm, p = 0.003), arterial hypertension (59% (n = 13/22) vs. 23% (n = 11/47), p = 0.004) and tobacco use (64% (n = 14/22) vs. 32% (n = 15/47), p = 0.01) were significantly greater in moderate/severe OSAS than in absent/mild OSAS. CONCLUSIONS Transferrin saturation was associated with OSAS severity and time under hypoxia. This suggests a relationship between OSAS-induced hypoxia and iron metabolism among obese patients.
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Du YR, Shi HX, Yu JS, Wu-Lan NR, Qian X, Zhong HY. Effect of positive end-expiratory pressure ventilation on plasma nitric oxide, endothelin-1 and vascular celladhesion molecule-1 levels in patients undergoing uvulopalatopharyngoplasty. Technol Health Care 2020; 29:223-229. [PMID: 32568134 DOI: 10.3233/thc-202193] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND During uvulopalatopharyngoplasty (UPPP), cardiovascular adverse events may occur which can be harmful to patients. OBJECTIVE To evaluate the effect of the protective ventilation strategy on the function of vascular endothelial cells. METHODS Forty obstructive apnea syndrome (OSA) patients who underwent uvulopalatopharyngoplasty (UPPP) were enrolled. Patients were randomly divided into the control group (group C, PEEP = 0 cm H2O) and PEEP group (group P, PEEP = 5 cm H2O). Each group (n= 20) received intermittent volume controlled ventilation (VCV) with tidal volume 6 ml/kg of the predicted body weight, I:E 1:2, rate titrated for ETCO2 35-45, FiO2 0.7. Blood from the radial artery was sampled for blood gas analysis at four time points: the fifth minute of inhaling pure oxygen (T0), after tracheal intubation (T1), at the end of the operation (T2), and 20 minutes after extubation (T3). Three ml of arterial blood was retained, preserved at -20∘C after serum isolation, and plasma nitric oxide (NO), endothelin-1 (ET-1) and vascular celladhesion molecule-1 (VCAM-1) levels were determined by enzyme linked immunosorbent assay (ELISA). RESULTS Compared with group C, plasma ET-1 at T3 decreased in group P, and plasma NO levels at T2 and T3 increased (P< 0.05). Compared with samples collected at T0, plasma VCAM-1 levels at T1, T2 and T3 increased in group C, while plasma VCAM-1 levels at T2 and T3 decreased in group P (P< 0.05). Compared with group C, plasma VCAM-1 levels T2 and T3 decreased in group P (P< 0.05). CONCLUSIONS Positive end-expiratory pressure (PEEP) ventilation has a protective effect on vascular endothelial cell function in patients during UPPP.
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Free Radical Oxidation and Sleep Disorders in Andro- and Menopause (Literature Review). ACTA BIOMEDICA SCIENTIFICA 2020. [DOI: 10.29413/abs.2020-5.1.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This review presents data on changes in the physiology of sleep during reproductive aging. It is noted that insomnia and obstructive sleep apnea syndrome (OSAS) are the main sleep disorders. The results of foreign and domestic studies in the field of free radical oxidation during sleep deprivation in animal models are presented, indicating the dependence of processes on the duration of sleep deprivation. The largest number of studies of free radical processes in a person with somnological pathology was carried out in the study of OSAS. Blood, urine, saliva, condensate of exhaled air can be biomaterial for determining the parameters of free radical oxidation. It was shown that the intensity of oxidative stress depends on the severity of OSAS, as evidenced by the positive correlation of the level of active products of thiobarbituric acid, the products of oxidation of proteins and carbonyl groups with the apnea/hypopnea index, determining the development of not only oxidative, but also carbonyl stress in patients with a severe degree OSAS. Biomarkers such as thioredoxin, malondialdehyde, superoxide dismutase, and reduced iron have shown a more stable relationship between increased oxidative stress and OSA. Despite the results obtained, the question of the association of oxidative stress and hypoxia in OSA remains debatable, which is associated with the opposite results of some studies. Insomnia, which occurs mainly in females, is accompanied by a high level of end products of lipid peroxidation with a decrease in the activity of antioxidants such as paraoxonase, an enzymatic component of the glutathione system. Along with this, menopausal women present low levels of uric acid, which correlates with high scores of the Pittsburgh sleep quality index questionnaire. Recent studies have identified an association between the activity of the «lipoperoxidation – antioxidants» system and the Clock 3111T/C gene polymorphism in menopausal Caucasian women, indicating the protective role of the minor allele.
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Kolesnikova LI, Semenova NV, Osipova EV, Madaeva IM. [Lipid status and oxidative stress in menopausal women with obstructive apnea syndrome]. TERAPEVT ARKH 2019; 91:48-53. [PMID: 32598631 DOI: 10.26442/00403660.2019.10.000050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Indexed: 11/22/2022]
Abstract
AIM to assess lipid profile, lipid peroxidation and antioxidant system parameters in peri - and postmenopausal women with obstructive sleep apnea syndrome (OSAS). MATERIALS AND METHODS 37 perimenopausal women and 43 postmenopausal ones were examined. OSAS diagnosis was made on the basis of the clinical picture and the polysomnography results. In perimenopause, the main group consisted of 18 women, in postmenopausal women - 17. All comparison groups are comparable by age and body mass index. Lipid profile, lipid peroxidation and antioxidant system parameters by spectrophotometric methods were determined. Non - parametric criteria were used to analyze the group differences for the independent samples. RESULTS AND DISCUSSION The increase of total cholesterol (TC) and low - density lipoprotein cholesterol (LDL-C) levels were observed in perimenopausal women with OSAS as compared to control. The increase of TC, triacylglycerol (TG), LDL-C, very - low - density lipoprotein cholesterol (VLDL-C) levels and decrease of high - density lipoprotein cholesterol (HDL-D) level were found in postmenopausal women with OSAS as compared to control. Accumulation of ketodienes and conjugated trienes in perimenopausal women with OSAS and thiobarbituric acid reactants with a decrease of total antioxidant activity of blood serum in postmenopausal women with OSAS as compared to control was observed. Moreover, postmenopausal women with OSAS have a higher lipid peroxidation substrates and diene conjugates levels with a lower α-tocopherol level and total antioxidant activity compared with perimenopausal patients.The integral indicator of oxidative stress assessment indicates an imbalance in the lipid peroxidation and antioxidant system in menopausal women with OSAS. CONCLUSION The results obtained indicate a violation of lipid metabolism and the development of oxidative stress in patients with OSAS. This is most pronounced in the postmenopause due to the aggravation of the pathological condition.
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Affiliation(s)
- L I Kolesnikova
- Scientific Centre for Family Health and Human Reproduction Problems
| | - N V Semenova
- Scientific Centre for Family Health and Human Reproduction Problems
| | - E V Osipova
- Scientific Centre for Family Health and Human Reproduction Problems
| | - I M Madaeva
- Scientific Centre for Family Health and Human Reproduction Problems
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14
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Andrade AG, Bubu OM, Varga AW, Osorio RS. The Relationship between Obstructive Sleep Apnea and Alzheimer's Disease. J Alzheimers Dis 2019; 64:S255-S270. [PMID: 29782319 DOI: 10.3233/jad-179936] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Obstructive sleep apnea (OSA) and Alzheimer's disease (AD) are highly prevalent conditions with growing impact on our aging society. While the causes of OSA are now better characterized, the mechanisms underlying AD are still largely unknown, challenging the development of effective treatments. Cognitive impairment, especially affecting attention and executive functions, is a recognized clinical consequence of OSA. A deeper contribution of OSA to AD pathogenesis is now gaining support from several lines of research. OSA is intrinsically associated with disruptions of sleep architecture, intermittent hypoxia and oxidative stress, intrathoracic and hemodynamic changes as well as cardiovascular comorbidities. All of these could increase the risk for AD, rendering OSA as a potential modifiable target for AD prevention. Evidence supporting the relevance of each of these mechanisms for AD risk, as well as a possible effect of AD in OSA expression, will be explored in this review.
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Affiliation(s)
- Andreia G Andrade
- Department of Neurology, Alzheimer's Disease Center, NYU Langone Medical Center, New York, NY, USA.,Department of Psychiatry, Center for Brain Health, NYU Langone Medical Center, New York, NY, USA
| | - Omonigho M Bubu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Andrew W Varga
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ricardo S Osorio
- Department of Psychiatry, Center for Brain Health, NYU Langone Medical Center, New York, NY, USA.,Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, NY, USA
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15
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Abuyassin B, Badran M, Ayas NT, Laher I. The antioxidant α-lipoic acid attenuates intermittent hypoxia-related renal injury in a mouse model of sleep apnea. Sleep 2019; 42:5382296. [DOI: 10.1093/sleep/zsz066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/08/2019] [Indexed: 12/25/2022] Open
Affiliation(s)
- Bisher Abuyassin
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Badran
- Departments of Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Najib T Ayas
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ismail Laher
- Departments of Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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16
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Taveira KVM, Kuntze MM, Berretta F, de Souza BDM, Godolfim LR, Demathe T, De Luca Canto G, Porporatti AL. Association between obstructive sleep apnea and alcohol, caffeine and tobacco: A meta-analysis. J Oral Rehabil 2018; 45:890-902. [DOI: 10.1111/joor.12686] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/30/2018] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | | | | | | | - Graziela De Luca Canto
- Department of Dentistry; Brazilian Centre for Evidence-based Research; Federal University of Santa Catarina; Florianópolis Brazil
| | - André Luís Porporatti
- Department of Dentistry; Brazilian Centre for Evidence-based Research; Federal University of Santa Catarina; Florianópolis Brazil
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17
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Garbarino S, Scoditti E, Lanteri P, Conte L, Magnavita N, Toraldo DM. Obstructive Sleep Apnea With or Without Excessive Daytime Sleepiness: Clinical and Experimental Data-Driven Phenotyping. Front Neurol 2018; 9:505. [PMID: 29997573 PMCID: PMC6030350 DOI: 10.3389/fneur.2018.00505] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/08/2018] [Indexed: 12/15/2022] Open
Abstract
Introduction: Obstructive sleep apnea (OSA) is a serious and prevalent medical condition with major consequences for health and safety. Excessive daytime sleepiness (EDS) is a common-but not universal-accompanying symptom. The purpose of this literature analysis is to understand whether the presence/absence of EDS is associated with different physiopathologic, prognostic, and therapeutic outcomes in OSA patients. Methods: Articles in English published in PubMed, Medline, and EMBASE between January 2000 and June 2017, focusing on no-EDS OSA patients, were critically reviewed. Results: A relevant percentage of OSA patients do not complain of EDS. EDS is a significant and independent predictor of incident cardiovascular disease (CVD) and is associated with all-cause mortality and an increased risk of metabolic syndrome and diabetes. Male gender, younger age, high body mass index, are predictors of EDS. The positive effects of nasal continuous positive airway pressure (CPAP) therapy on blood pressure, insulin resistance, fatal and non-fatal CVD, and endothelial dysfunction risk factors have been demonstrated in EDS-OSA patients, but results are inconsistent in no-EDS patients. The most sustainable cause of EDS is nocturnal hypoxemia and alterations of sleep architecture, including sleep fragmentation. These changes are less evident in no-EDS patients that seem less susceptible to the cortical effects of apneas. Conclusions: There is no consensus if we should consider OSA as a single disease with different phenotypes with or without EDS, or if there are different diseases with different genetic/epigenetic determinants, pathogenic mechanisms, prognosis, and treatment.The small number of studies focused on this issue indicates the need for further research in this area. Clinicians must carefully assess the presence or absence of EDS and decide accordingly the treatment. This approach could improve combination therapy targeted to a patient's specific pathology to enhance both efficacy and long-term adherence to OSA treatment and significantly reduce the social, economic, and health negative impact of OSA.
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Affiliation(s)
- Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, Genoa, Italy.,Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Egeria Scoditti
- Institute of Clinical Physiology, National Research Council (CNR), Lecce, Italy
| | - Paola Lanteri
- Department of Neurological Science, G. Gaslini Institute, Genoa, Italy
| | - Luana Conte
- Interdisciplinary Laboratory of Applied Research in Medicine (DReAM), "V Fazzi" University Hospital, ASL Lecce, Lecce, Italy.,Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy
| | - Nicola Magnavita
- Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Domenico M Toraldo
- Rehabilitation Department, Cardio-Respiratory Care Unit, "V Fazzi" Hospital, ASL Lecce, Lecce, Italy
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18
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Üstündağ Y, Demirci H, Balık R, Erel O, Özaydın F, Kücük B, Ertaş D, Ustunyurt E. Thiol/disulfide homeostasis in pregnant women with obstructive sleep apnea syndrome. J Matern Fetal Neonatal Med 2017; 32:1136-1141. [DOI: 10.1080/14767058.2017.1401995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Yasemin Üstündağ
- Clinical Biochemistry, Saglik Bilimleri University, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Hakan Demirci
- Family Medicine, Saglik Bilimleri University, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Rifat Balık
- Ankara Atatürk Training and Research Hospital, Biochemistry, Ankara, Turkey
| | - Ozcan Erel
- Department of Biochemistry, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey
| | - Fahri Özaydın
- Family Medicine, Saglik Bilimleri University, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Bilgen Kücük
- Family Medicine, Saglik Bilimleri University, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Dilber Ertaş
- Family Medicine, Saglik Bilimleri University, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Emin Ustunyurt
- Obstetrics and Gynecology, Saglik Bilimleri University, Bursa Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
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19
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Laus MN, Soccio M, Alfarano M, Pasqualone A, Lenucci MS, Di Miceli G, Pastore D. Different effectiveness of two pastas supplemented with either lipophilic or hydrophilic/phenolic antioxidants in affecting serum as evaluated by the novel Antioxidant/Oxidant Balance approach. Food Chem 2016; 221:278-288. [PMID: 27979203 DOI: 10.1016/j.foodchem.2016.10.050] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/11/2016] [Accepted: 10/11/2016] [Indexed: 12/22/2022]
Abstract
Effectiveness in improving serum antioxidant status of two functional pastas was evaluated by the novel Antioxidant/Oxidant Balance (AOB) parameter, calculated as Antioxidant Capacity (AC)/Peroxide Level ratio, assessed here for the first time. In particular, Bran Oleoresin (BO) and Bran Water (BW) pastas, enriched respectively with either lipophilic (tocochromanols, carotenoids) or hydrophilic/phenolic antioxidants extracted from durum wheat bran, were studied. Notably, BO pasta was able to improve significantly (+65%) serum AOB during four hours after intake similarly to Lisosan G, a wheat antioxidant-rich dietary supplement. Contrarily, BW pasta had oxidative effect on serum so as conventional pasta and glucose, thus suggesting greater effectiveness of lipophilic than hydrophilic/phenolic antioxidants under our experimental conditions. Interestingly, no clear differences between the two pastas were observed, when AC measurements of either serum after pasta intake or pasta extracts by in vitro assays were considered, thus strengthening effectiveness and reliability of AOB approach.
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Key Words
- AAPH, 2,2′-azobis(2-methylpropionamidine) dihydrochloride (PubChem CID: 76344)
- ABTS, diammonium-2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonate) (PubChem CID: 9570474)
- DPPD, N,N-diethyl-p-phenylenediamine (PubChem CID: 7120)
- Durum wheat antioxidants
- Fluorescein, 3′,6′-dihydroxy-3H-spiro[2-benzofuran-1,9′-xanthen]-3-one (PubChem CID: 16850)
- Functional pasta
- Human serum
- LOX-FL
- Linoleic acid sodium salt (PubChem CID: 23702140)
- Lisosan G
- ORAC
- TEAC
- Trolox, (±)-6-hydroxy-2,5,7,8-tetramethylchromane-2-carboxylic acid (PubChem CID: 40634).
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Affiliation(s)
- Maura N Laus
- Dipartimento di Scienze Agrarie, degli Alimenti e dell'Ambiente, Università degli Studi di Foggia, Via Napoli, 25, 71122 Foggia, Italy.
| | - Mario Soccio
- Dipartimento di Scienze Agrarie, degli Alimenti e dell'Ambiente, Università degli Studi di Foggia, Via Napoli, 25, 71122 Foggia, Italy.
| | - Michela Alfarano
- Dipartimento di Scienze Agrarie, degli Alimenti e dell'Ambiente, Università degli Studi di Foggia, Via Napoli, 25, 71122 Foggia, Italy.
| | - Antonella Pasqualone
- Dipartimento di Scienze del Suolo, della Pianta e degli Alimenti, Università di Bari "Aldo Moro", Via Amendola, 165A, 70126 Bari, Italy.
| | - Marcello S Lenucci
- Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali, Università del Salento, Via Prov.le Lecce-Monteroni, 73100 Lecce, Italy.
| | - Giuseppe Di Miceli
- Dipartimento di Scienze Agrarie e Forestali, Università degli Studi di Palermo, Viale delle Scienze, 90128 Palermo, Italy; Fondazione Angelo e Salvatore Lima Mancuso, Piazza Marina, 61, 90100 Palermo, Italy.
| | - Donato Pastore
- Dipartimento di Scienze Agrarie, degli Alimenti e dell'Ambiente, Università degli Studi di Foggia, Via Napoli, 25, 71122 Foggia, Italy.
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20
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Role of Oxidative Stress in the Neurocognitive Dysfunction of Obstructive Sleep Apnea Syndrome. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:9626831. [PMID: 27774119 PMCID: PMC5059616 DOI: 10.1155/2016/9626831] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 09/01/2016] [Indexed: 01/28/2023]
Abstract
Obstructive sleep apnea syndrome (OSAS) is characterized by chronic nocturnal intermittent hypoxia and sleep fragmentations. Neurocognitive dysfunction, a significant and extraordinary complication of OSAS, influences patients' career, family, and social life and reduces quality of life to some extent. Previous researches revealed that repetitive hypoxia and reoxygenation caused mitochondria and endoplasmic reticulum dysfunction, overactivated NADPH oxidase, xanthine oxidase, and uncoupling nitric oxide synthase, induced an imbalance between prooxidants and antioxidants, and then got rise to a series of oxidative stress (OS) responses, such as protein oxidation, lipid peroxidation, and DNA oxidation along with inflammatory reaction. OS in brain could trigger neuron injury especially in the hippocampus and cerebral cortex regions. Those two regions are fairly susceptible to hypoxia and oxidative stress production which could consequently result in cognitive dysfunction. Apart from continuous positive airway pressure (CPAP), antioxidant may be a promising therapeutic method to improve partially reversible neurocognitive function. Understanding the role that OS played in the cognitive deficits is crucial for future research and therapeutic strategy development. In this paper, recent important literature concerning the relationship between oxidative stress and cognitive impairment in OSAS will be summarized and the results can provide a rewarding overview for future breakthrough in this field.
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21
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Choi KM, Thomas RJ, Yoon DW, Lee SK, Baik I, Shin C. Interaction between Obstructive Sleep Apnea and Shortened Telomere Length on Brain White Matter Abnormality. Sleep 2016; 39:1639-45. [PMID: 27397571 DOI: 10.5665/sleep.6082] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 05/23/2016] [Indexed: 12/25/2022] Open
Abstract
STUDY OBJECTIVES Age-related brain white matter changes (WMC) have been associated separately with obstructive sleep apnea (OSA) and short telomere length (TL). No studies have examined their interaction effect on WMC. METHODS This is a cross-sectional study with a community-based sample of 420 participants (mean age, 61.3 ± 7.2) from the Korean Genome and Epidemiology Study during 2011-2012. An overnight fasted blood sample was taken to determine glucose and blood lipid levels at the sleep laboratory of Korea University Ansan Hospital. The status of brain WMC was determined using structural magnetic resonance imaging at 1.5 Tesla. Overnight polysomnography was performed, and leukocyte TL was measured. OSA was determined based on apnea-hypopnea index, and short TL was defined as the lowest quartile of the study participants. RESULTS Adjusting for age, sex, BMI, smoking, drinking, snoring, and hypertension, odds ratio (OR) of brain WMC was estimated using multivariate logistic regression. The odds ratio was significant for cardiovascular disease (OR, 4.5; 95% CI, 1.2-16.3) and OSA (OR, 4.0; 95% CI, 1.0-15.2) among those with short TL; and for diabetes (OR, 3.0; 95% CI, 1.3-13.0) and age (OR, 1.1; 95% CI, 1.0-1.1) among those with longer TL. Interaction effect of OSA and short TL (OR, 4.3; 95% CI, 1.4-13.8) was significant, compared to those with neither OSA nor short TL. CONCLUSIONS This study provides a first evidence of mediated interaction of short TL with OSA on brain WMC in a community-based sample. The results generate new hypotheses regarding mechanisms of impaired brain health in sleep apnea.
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Affiliation(s)
- Kyung-Mee Choi
- Korea University Ansan Hospital, Institute of Human Genomic Study, Korea
| | - Robert J Thomas
- Division of Pulmonary Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Dai Wui Yoon
- Korea University Ansan Hospital, Institute of Human Genomic Study, Korea
| | - Seung Ku Lee
- Korea University Ansan Hospital, Institute of Human Genomic Study, Korea
| | | | - Chol Shin
- Korea University Ansan Hospital, Institute of Human Genomic Study, Korea.,Korea University Ansan Hospital, Internal Medicine, Division of Sleep and Critical Care Medicine, Korea
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22
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Olaithe M, Eastwood PR, Bucks RS, Deacon NL, Malhotra A, Kumar VHS, Zuo L, Chuang CC, Schotland H. Commentaries on Viewpoint: Hypercapnia is more important than hypoxia in the neuro-outcomes of sleep-disordered breathing. J Appl Physiol (1985) 2016; 120:1487-8. [PMID: 27306842 DOI: 10.1152/japplphysiol.00327.2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- M Olaithe
- University of Western AustraliaUniversity of California, San DiegoUniversity at BuffaloThe Ohio State University College of MedicineUniversity of Michigan
| | - P R Eastwood
- University of Western AustraliaUniversity of California, San DiegoUniversity at BuffaloThe Ohio State University College of MedicineUniversity of Michigan
| | - R S Bucks
- University of Western AustraliaUniversity of California, San DiegoUniversity at BuffaloThe Ohio State University College of MedicineUniversity of Michigan
| | - Naomi L Deacon
- University of Western AustraliaUniversity of California, San DiegoUniversity at BuffaloThe Ohio State University College of MedicineUniversity of Michigan
| | - Atul Malhotra
- University of Western AustraliaUniversity of California, San DiegoUniversity at BuffaloThe Ohio State University College of MedicineUniversity of Michigan
| | - Vasantha H S Kumar
- University of Western AustraliaUniversity of California, San DiegoUniversity at BuffaloThe Ohio State University College of MedicineUniversity of Michigan
| | - Li Zuo
- University of Western AustraliaUniversity of California, San DiegoUniversity at BuffaloThe Ohio State University College of MedicineUniversity of Michigan
| | - Chia-Chen Chuang
- University of Western AustraliaUniversity of California, San DiegoUniversity at BuffaloThe Ohio State University College of MedicineUniversity of Michigan
| | - Helena Schotland
- University of Western AustraliaUniversity of California, San DiegoUniversity at BuffaloThe Ohio State University College of MedicineUniversity of Michigan
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23
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Lira AB, de Sousa Rodrigues CF. Evaluation of oxidative stress markers in obstructive sleep apnea syndrome and additional antioxidant therapy: a review article. Sleep Breath 2016; 20:1155-1160. [DOI: 10.1007/s11325-016-1367-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/05/2016] [Accepted: 05/25/2016] [Indexed: 12/20/2022]
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24
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Ferrandez B, Ferreras A, Calvo P, Abadia B, Pajarin AB, Marin JM, Iester M. Macular Retinal Ganglion Cell Layer Thickness Is Not Reduced in Patients with Obstructive Sleep Apnea. Ophthalmic Res 2016; 56:85-91. [PMID: 27192975 DOI: 10.1159/000445353] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 03/10/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate macular ganglion cell layer (GCL) and ganglion cell-inner plexiform layer (GCIPL) thicknesses in patients with obstructive sleep apnea (OSA) syndrome. METHODS 73 OSA patients and 67 age-matched controls were consecutively and prospectively enrolled. All participants underwent at least one reliable standard automated perimetry (SAP) and were imaged with spectral-domain optical coherence tomography (OCT) using two different devices. The OCT parameters were compared between groups, and Pearson correlations between main indices of SAP and OCT parameters were calculated. RESULTS The pattern standard deviation of SAP was higher in the OSA group (p = 0.001). Mean GCIPL thickness was 82.99 ± 10.30 and 80.78 ± 12.15 µm in the control and OSA groups, respectively (p = 0.25), and GCL thickness was 44.93 ± 11.42 µm in the control group and 48.81 ± 10.85 µm in OSA individuals (p = 0.47). Pearson correlations between the GCIPL-GCL measurements and the main indices of SAP were not significant. CONCLUSIONS Neither GCIPL nor GCL thickness were reduced in OSA subjects compared with healthy individuals. Retinal sensitivity evaluated with SAP was however decreased in OSA patients.
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Affiliation(s)
- Blanca Ferrandez
- Department of Ophthalmology, IIS-Aragx00F3;n, Miguel Servet University Hospital, Zaragoza, Spain
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25
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Is there an effect of obstructive sleep apnea syndrome on oxidative stress and inflammatory parameters in patients with craniofacial anomalies? J Craniofac Surg 2015; 24:1908-13. [PMID: 24220372 DOI: 10.1097/scs.0b013e3182a41c05] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to test the hypothesis that obstructive sleep apnea syndrome (OSAS) exhibits oxidative stress and inflammation in patients who have a congenital, craniofacial anomaly.This prospective, cross-sectional cohort study included ambulant sleep study data to asses OSAS in patients with syndromic craniosynostosis and Treacher Collins syndrome. Laboratory analyses were performed including malondialdehyde, tumor necrosis factor α (TNF-α), interleukin 6, and high-sensitivity C-reactive protein.Forty-eight patients were included; 11 were adults; 37 were children. The patients' body mass indexes were normal, with a median (SD) of 0.7 (-1.82 to 2.48) in children and 20.5 (15.2-29.4) in adults. Obstructive sleep apnea syndrome was diagnosed in 23 of 48 patients. It was mild (median obstructive apnea-hypopnea index [oAHI], 2.3; oxygenation-desaturation index [ODI], 0.9) in 16 patients and moderate/severe in 7 patients (median oAHI, 10.8; ODI, 5.0). Neither oxidative stress nor inflammation had a correlation with the oAHI and ODI. Only TNF-α was found significantly higher in both the OSAS and non-OSAS groups compared with the reference values (median, 15.1 pg/mL and 12.3 pg/mL versus 4.05 [0.0-8.1 pg/mL], P < 0.001 and P < 0.001, respectively).Based on our findings we conclude that (mainly mild) OSAS, oxidative stress, as well as high-sensitivity C-reactive protein and interleukin 6 levels are not abnormal in the day time in a population of nonobese patients with a craniofacial anomaly. The increased level of TNF-α cannot be explained by OSAS. Future research should focus on mapping chronobiologic changes for further interpretation of the results.
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26
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Martines F, Ballacchino A, Sireci F, Mucia M, La Mattina E, Rizzo S, Salvago P. Audiologic profile of OSAS and simple snoring patients: the effect of chronic nocturnal intermittent hypoxia on auditory function. Eur Arch Otorhinolaryngol 2015; 273:1419-24. [PMID: 26164293 DOI: 10.1007/s00405-015-3714-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 07/03/2015] [Indexed: 02/06/2023]
Abstract
The objective of this work was to study the effect of nocturnal intermittent hypoxia on auditory function of simple snoring patients and subjects affected by OSAS; we compared the audiologic profile with the severity of OSAS to detect early signs of cochlear damage. One hundred-sixty patients underwent overnight polysomnography, micro-otoscopy, multi-frequency audiometry, acufenometry, TEOAE recording and d-ROMs test. All subjects were divided in four groups, based on presence/absence of AHI (simple snoring without OSAS, mild OSAS, moderate OSAS, severe OSAS). Sixty (37.5 %) patients were not affected by OSAS, 58 (36.25 %) presented a mild OSAS, 18 (11.25 %) a moderate OSAS and 24 (15 %) a severe OSAS; the 57.14 % of moderate to severe OSAS suffered from tinnitus with respect to the 31.03 % of mild OSAS (P = 0.024). A higher percentage (41.66 %) of hearing loss was found among individuals with moderate to severe degree of OSAS (P < 0.0001). All groups were characterized by a mean hearing threshold <25 dB HL for 0.25-3 kHz frequencies and a progressive decrease in hearing sensitivity, particularly for 6-16 kHz frequencies (P < 0.05). The analysis of otoacoustic emissions SNR mean values evidenced a significant difference between simple snoring and severe OSAS individuals for 3 and 4 kHz frequencies (P < 0.05). d-ROM levels resulted higher in patients with severe OSAS with respect to simple snoring subjects (P = 0.004). Our data underline the key role of chronic nocturnal intermittent hypoxia in the development of an early cochlear damage and a more marked high-frequency hearing loss in case of severe OSAS (P < 0.05).
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Affiliation(s)
- Francesco Martines
- Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, (BioNeC), Sezione di Otorinolaringoiatria, Università degli Studi di Palermo, Via del Vespro, 129-90127, Palermo, Italy
| | - Antonella Ballacchino
- Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi (Di.Bi.Me.F.), Sezione di Audiologia, Università degli Studi di Palermo, Via del Vespro, 129-90127, Palermo, Italy
| | - Federico Sireci
- Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, (BioNeC), Sezione di Otorinolaringoiatria, Università degli Studi di Palermo, Via del Vespro, 129-90127, Palermo, Italy
| | - Marianna Mucia
- Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, (BioNeC), Sezione di Otorinolaringoiatria, Università degli Studi di Palermo, Via del Vespro, 129-90127, Palermo, Italy
- Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi (Di.Bi.Me.F.), Sezione di Audiologia, Università degli Studi di Palermo, Via del Vespro, 129-90127, Palermo, Italy
| | - Eleonora La Mattina
- Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi (Di.Bi.Me.F.), Sezione di Audiologia, Università degli Studi di Palermo, Via del Vespro, 129-90127, Palermo, Italy
| | - Serena Rizzo
- Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi (Di.Bi.Me.F.), Sezione di Audiologia, Università degli Studi di Palermo, Via del Vespro, 129-90127, Palermo, Italy
| | - Pietro Salvago
- Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, (BioNeC), Sezione di Otorinolaringoiatria, Università degli Studi di Palermo, Via del Vespro, 129-90127, Palermo, Italy.
- , Via Gioacchino Di Marzo, 37-90144, Palermo, Italy.
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De Luca Canto G, Pachêco-Pereira C, Aydinoz S, Major PW, Flores-Mir C, Gozal D. Diagnostic capability of biological markers in assessment of obstructive sleep apnea: a systematic review and meta-analysis. J Clin Sleep Med 2015; 11:27-36. [PMID: 25325575 DOI: 10.5664/jcsm.4358] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 09/11/2014] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The purpose of this systematic review is to evaluate the diagnostic value of biological markers (exhaled breath condensate, blood, salivary and urinary) in the diagnosis of OSA in comparison to the gold standard of nocturnal PSG. METHODS Studies that differentiated OSA from controls based on PSG results, without age restriction, were eligible for inclusion. The sample of selected studies could include studies in obese patients and with known cardiac disease. A detailed individual search strategy for each of the following bibliographic databases was developed: Cochrane, EMBASE, MEDLINE, PubMed, and LILACS. The references cited in these articles were also crosschecked and a partial grey literature search was undertaken using Google Scholar. The methodology of selected studies was evaluated using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies. RESULTS After a two-step selection process, nine articles were identified and subjected to qualitative and quantitative analyses. Among them, only one study conducted in children and one in adults found biomarkers that exhibit sufficiently satisfactory diagnostic accuracy that enables application as a diagnostic method for OSA. CONCLUSION Kallikrein-1, uromodulin, urocotin-3, and orosomucoid-1 when combined have enough accuracy to be an OSA diagnostic test in children. IL-6 and IL-10 plasma levels have potential to be good biomarkers in identifying or excluding the presence of OSA in adults.
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Affiliation(s)
- Graziela De Luca Canto
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil.,School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | | | - Secil Aydinoz
- GATA Haydarpasa Teaching Hospital, Istanbul, Turkey.,Department of Pediatrics, University of Chicago, Chicago, IL
| | - Paul W Major
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - David Gozal
- Department of Pediatrics, University of Chicago, Chicago, IL
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Canto GDL, Pachêco-Pereira C, Aydinoz S, Major PW, Flores-Mir C, Gozal D. Biomarkers associated with obstructive sleep apnea: A scoping review. Sleep Med Rev 2014; 23:28-45. [PMID: 25645128 DOI: 10.1016/j.smrv.2014.11.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 11/12/2014] [Accepted: 11/12/2014] [Indexed: 12/31/2022]
Abstract
The overall validity of biomarkers in the diagnosis of obstructive sleep apnea (OSA) remains unclear. We conducted a scoping review to provide assessments of biomarkers characteristics in the context of obstructive sleep apnea (OSA) and to identify gaps in the literature. A scoping review of studies in humans without age restriction that evaluated the potential diagnostic value of biological markers (blood, exhaled breath condensate, salivary, and urinary) in the OSA diagnosis was undertaken. Retained articles were those focused on the identification of biomarkers in subjects with OSA, the latter being confirmed with a full overnight or home-based polysomnography (PSG). Search strategies for six different databases were developed. The methodology of selected studies was classified using an adaptation of the evidence quality criteria from the American Academy of Pediatrics. Additionally the biomarkers were classified according to their potential clinical application. We identified 572 relevant studies, of which 117 met the inclusion criteria. Eighty-two studies were conducted in adults, 34 studies involved children, and one study had a sample composed of both adults and children. Most of the studies evaluated blood biomarkers. Potential diagnostic biomarkers were found in nine pediatric studies and in 58 adults studies. Only nine studies reported sensitivity and specificity, which varied substantially from 43% to 100%, and from 45% to 100%, respectively. Studies in adults have focused on the investigation of IL-6, TNF-α and hsCRP. There was no specific biomarker that was tested by a majority of authors in pediatric studies, and combinatorial urine biomarker approaches have shown preliminary promising results. In adults IL-6 and IL-10 seem to have a favorable potential to become a good biomarker to identify OSA.
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Affiliation(s)
- Graziela De Luca Canto
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil; School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | | | - Secil Aydinoz
- GATA Haydarpasa Teaching Hospital, Istanbul, Turkey; Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, USA
| | - Paul W Major
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada
| | - David Gozal
- Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, USA; Comer Children's Hospital, USA.
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Biomarkers to improve diagnosis and monitoring of obstructive sleep apnea syndrome: current status and future perspectives. Pulm Med 2014; 2014:930535. [PMID: 25538852 PMCID: PMC4265695 DOI: 10.1155/2014/930535] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 10/23/2014] [Indexed: 02/06/2023] Open
Abstract
Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of upper airway collapse associated with oxygen desaturation and sleep disruption. It is proposed that these periodic changes lead to molecular variations that can be detected by assessing serum biomarkers. Studies have identified inflammatory, oxidative, and metabolic perturbations attributable to sleep-disordered breathing. Given that OSAS is associated with increased cardiovascular and cerebrovascular morbidity, the ideal biomarker should enable timely recognition with the possibility of intervention. There is accumulating data on the utility of serum biomarkers for the evaluation of disease severity, prognosis, and response to treatment. However, current knowledge is limited by data collection techniques, disease complexity, and potential confounding factors. The current paper reviews the literature on the use of serum biomarkers in OSAS. It is concluded that the ideal serum biomarker still needs to be discovered, while caution is needed in the interpretation of hitherto available results.
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Ozben S, Huseyinoglu N, Hanikoglu F, Guvenc TS, Yildirim BZ, Cort A, Ozdem S, Ozben T. Advanced oxidation protein products and ischaemia-modified albumin in obstructive sleep apnea. Eur J Clin Invest 2014; 44:1045-52. [PMID: 25223839 DOI: 10.1111/eci.12338] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 09/07/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND Several studies have shown that obstructive sleep apnea increases incidence of cardiovascular morbidity and mortality. The high systemic oxidative stress in obstructive sleep apnea has been considered as a major pathogenic mechanism leading to cardiovascular disease. Oxidative stress-related lipid and DNA oxidation in obstructive sleep apnea have been reported in the previous studies. In contrast, there is limited and contradictory information regarding protein oxidation in obstructive sleep apnea patients such as ischaemia-modified albumin and advanced oxidation protein products. Therefore, we aimed to investigate plasma ischaemia-modified albumin and advanced oxidation protein products and their correlation with total oxidative status and total antioxidative capacity in the obstructive sleep apnea patients. METHODS Plasma ischaemia-modified albumin, advanced oxidation protein products, total oxidative status and total antioxidative capacity were measured in 25 healthy volunteers and 59 obstructive sleep apnea patients diagnosed with polysomnography. RESULTS Plasma total antioxidative capacity was significantly lower (P = 0·012) and total oxidative status was significantly higher (P < 0·001) in the patients compared to the controls demonstrating increased oxidative stress in the patients. Plasma advanced oxidation protein products were significantly higher in the patients than the controls (P = 0·024). Plasma ischaemia-modified albumin levels were not statistically different between the obstructive sleep apnea patients and controls (P = 0·74). CONCLUSIONS We conclude that high systemic oxidative stress in obstructive sleep apnea is reflected by increased advanced oxidation protein products without causing an increase in ischaemia-modified albumin.
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Affiliation(s)
- Serkan Ozben
- Department of Neurology, Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery Diseases, Istanbul, Turkey
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Higher dose of warfarin for patients with pulmonary embolism complicated by obstructive sleep apnea hypopnea syndrome. Heart Lung 2014; 43:358-62. [DOI: 10.1016/j.hrtlng.2014.04.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 04/03/2014] [Accepted: 04/04/2014] [Indexed: 11/22/2022]
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Badran M, Golbidi S, Devlin A, Ayas N, Laher I. Chronic intermittent hypoxia causes endothelial dysfunction in a mouse model of diet-induced obesity. Sleep Med 2014; 15:596-602. [DOI: 10.1016/j.sleep.2014.01.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 01/25/2014] [Accepted: 01/30/2014] [Indexed: 11/16/2022]
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Vassalle C, Vigna L, Bianchi S, Maffei S, Novembrino C, De Giuseppe R, de Liso F, Vannucci A, Tirelli S, Maiavacca R, Bamonti F. A biomarker of oxidative stress as a nontraditional risk factor in obese subjects. Biomark Med 2014; 7:633-9. [PMID: 23905900 DOI: 10.2217/bmm.13.49] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Oxidative stress has been postulated as an additive factor linking obesity to cardiovascular disease. MATERIALS & METHODS Derivatives of reactive oxygen species metabolites (d-ROMs) were measured in 136 obese (42 males, 94 females; mean age: 47 ± 12 years; BMI: 36 ± 5 kg/m(2)) and in 306 over- and normal-weight subjects (112 males, 194 females; age: 47 ± 12 years; BMI: 24 ± 3 kg/m(2)). RESULTS d-ROMs levels were higher in obese than in over- and normal-weight subjects (395 ± 104 vs 362 ± 102 and 351 ± 84 arbitrary units (AU); p < 0.001), in women than males (390 ± 104 vs 327 ± 68 AU; p < 0.001), in subjects with than those without hypertension (390 ± 103 vs 360 ± 95 AU; p < 0.01) and in smokers than former and nonsmokers (380 ± 97 vs 358 ± 97 AU; p < 0.05). A positive correlation was found between d-ROMs and BMI (r = 0.25; p < 0.001) and age (r = 0.13; p < 0.01). Levels of d-ROM (>75th percentile: 420 AU) remained as an independent obesity predictor (odds ratio: 2.5; p < 0.001) in women. Continuous variables are reported as mean ± standard deviation. CONCLUSION d-ROMs are a powerful obesity predictor, and could represent a reliable tool in obesity and cardiovascular risk evaluation, especially in women.
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Inflammatory lung disease in Rett syndrome. Mediators Inflamm 2014; 2014:560120. [PMID: 24757286 PMCID: PMC3976920 DOI: 10.1155/2014/560120] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 01/06/2014] [Accepted: 01/14/2014] [Indexed: 12/30/2022] Open
Abstract
Rett syndrome (RTT) is a pervasive neurodevelopmental disorder mainly linked to mutations in the gene encoding the methyl-CpG-binding protein 2 (MeCP2). Respiratory dysfunction, historically credited to brainstem immaturity, represents a major challenge in RTT. Our aim was to characterize the relationships between pulmonary gas exchange abnormality (GEA), upper airway obstruction, and redox status in patients with typical RTT (n = 228) and to examine lung histology in a Mecp2-null mouse model of the disease. GEA was detectable in ~80% (184/228) of patients versus ~18% of healthy controls, with “high” (39.8%) and “low” (34.8%) patterns dominating over “mixed” (19.6%) and “simple mismatch” (5.9%) types. Increased plasma levels of non-protein-bound iron (NPBI), F2-isoprostanes (F2-IsoPs), intraerythrocyte NPBI (IE-NPBI), and reduced and oxidized glutathione (i.e., GSH and GSSG) were evidenced in RTT with consequently decreased GSH/GSSG ratios. Apnea frequency/severity was positively correlated with IE-NPBI, F2-IsoPs, and GSSG and negatively with GSH/GSSG ratio. A diffuse inflammatory infiltrate of the terminal bronchioles and alveoli was evidenced in half of the examined Mecp2-mutant mice, well fitting with the radiological findings previously observed in RTT patients. Our findings indicate that GEA is a key feature of RTT and that terminal bronchioles are a likely major target of the disease.
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Wu CX, Liu Y, Zhang JC. Chronic intermittent hypoxia and hypertension: A review of systemic inflammation and Chinese Medicine. Chin J Integr Med 2013; 19:394-400. [DOI: 10.1007/s11655-013-1459-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Indexed: 01/14/2023]
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Levels of TBARS are inversely associated with lowest oxygen saturation in obese patients with OSAS. Sleep Breath 2013; 17:1319-22. [PMID: 23361138 DOI: 10.1007/s11325-013-0819-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 01/07/2013] [Accepted: 01/23/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE The aim of this study was to investigate the most important factors that determine lipid peroxidation in obese patients with obstructive sleep apnoea syndrome (OSAS). METHODS Twenty-one obese patients with OSAS based on overnight attended polysomnography were included. Thiobarbituric acid reactive substances (TBARS) were measured in serum. Anthropometric measurements were carried out. Dietary habits were assessed by a standardised food frequency questionnaire. RESULTS Spearman's correlation analysis showed significant positive correlations between TBARS and apnoea-hypopnoea index and desaturations/hour while negative between TBARS and mean/lowest oxygen saturation. The most significant predicting factor in the multiple linear regression model was lowest oxygen saturation. CONCLUSIONS This study has revealed an independent association between lowest oxygen saturation and TBARS levels after controlling for age, gender, diet and obesity in predominantly male patients with moderate to severe OSAS.
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Sánchez-de-la-Torre M, Campos-Rodriguez F, Barbé F. Obstructive sleep apnoea and cardiovascular disease. THE LANCET RESPIRATORY MEDICINE 2012; 1:61-72. [PMID: 24321805 DOI: 10.1016/s2213-2600(12)70051-6] [Citation(s) in RCA: 329] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Obstructive sleep apnoea (OSA) is a common health concern caused by repeated episodes of collapse of the upper airway during sleep. The events associated with OSA lead to brain arousal, intrathoracic pressure changes, and intermittent episodes of hypoxaemia and reoxygenation. These events activate pathways such as oxidative stress, sympathetic activation, inflammation, hypercoagulability, endothelial dysfunction, and metabolic dysregulation that predispose patients with OSA to hypertension and atherosclerosis. OSA is a common cause of systemic hypertension and should be suspected in hypertensive individuals, especially those with resistant hypertension. In patients with OSA, continuous positive airway pressure (CPAP) treatment reduces blood pressure, and its effects are related to compliance and baseline blood pressure. Evidence suggests that OSA is a risk factor for stroke and heart failure. An association between coronary heart disease and OSA seems to be limited to middle-aged men (30-70 years). Cardiac rhythm disorders occur in about half of patients with OSA, but their clinical relevance is still unknown. The association of OSA with cardiovascular risk is mainly based on studies in men, and an association has yet to be established in women. Data on older patients is similarly scarce. Currently, there is not enough evidence to support treatment with CPAP for primary or secondary prevention of cardiovascular disease.
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Affiliation(s)
- Manuel Sánchez-de-la-Torre
- Respiratory Department, Hospital Universitari Arnau de Vilanova-Santa María, IRB Lleida, Lleida, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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