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06.01.2022 | Sleep Breathing Physiology and Disorders • Original Article

Inflammation markers in moderate and severe obstructive sleep apnea: the influence of sex

verfasst von: Chiara Rocchi, Conti Valentina, Viviana Totaro, Serena Broggi, Simona Lattanzi, Giovanna Viticchi, Lorenzo Falsetti, Mauro Silvestrini, Laura Buratti

Erschienen in: Sleep and Breathing | Ausgabe 4/2022

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Abstract

Purpose

Obstructive sleep apnea (OSA) is the most prevalent sleep-related breathing disorder, with a negative impact on cardiovascular health. Different OSA symptoms and treatment response in males and females have been reported. The aim of this study was to investigate inflammatory markers in patients with OSA and the relationship of those markers to disease severity in male and female subjects.

Methods

We considered consecutive subjects referred to the outpatient Sleep Disorder Service of the Respiratory Medicine Department, San Marino Hospital. We included patients with a diagnosis of moderate or severe OSAS and an age range of 45–80 years. Concomitant inflammatory conditions were an exclusion criterion. A polygraphic study and a blood draw for inflammatory markers were performed for each subject.

Results

Of 110 subjects, 59 were males. Severe OSA affected 72 subjects. We analyzed data through a 4-level categorical variable according to sex and OSA severity (moderate OSA, males; severe OSA, males; moderate OSA, females; severe OSA, females), which showed significant differences for interleukin-6 (IL-6) and C-reactive protein (CRP) levels. A significant difference in IL-6 levels with a significant ascending trend (p = 0.045) from females with moderate OSAS to males with severe OSAS emerged in our pairwise comparison for estimated marginal means. Also, a significant trend (p = 0.0001) for CRP levels from males with moderate OSAS to females with severe OSAS was shown.

Conclusions

OSA and inflammation are interconnected, and both are associated with vascular diseases. Sex-related differences in OSA phenotypes may help the clinicians aim for a more personalized approach.

Salman LA, Shulman R, Cohen JB (2020) Obstructive sleep apnea, hypertension, and cardiovascular risk: epidemiology, pathophysiology, and management. Curr Cardiol Rep 22(2):6. https://doi.org/10.1007/s11886-020-1257-yCrossRefPubMed

Dewan NA, Nieto FJ, Somers VK (2015) Intermittent hypoxemia and OSA: implications for comorbidities. Chest 147(1):266–274. https://doi.org/10.1378/chest.14-0500CrossRefPubMedPubMedCentral

Stöwhas AC, Lichtblau M, Bloch KE. Obstructive sleep apnea syndrome. Praxis (Bern 1994) 2019;108:111–117. doi: https://doi.org/10.1024/1661-8157/a003198.

Redline S, Kump K, Tishler PV, Browner I, Ferrette V (1994) Gender differences in sleep disordered breathing in a community-based sample. Am J Respir Crit Care Med 149(3 Pt 1):722–726. https://doi.org/10.1164/ajrccm.149.3.8118642CrossRefPubMed

Poroyko VA, Carreras A, Khalyfa A et al (2016) Chronic sleep disruption alters gut microbiota, induces systemic and adipose tissue inflammation and insulin resistance in mice. Sci Rep 6:35405. https://doi.org/10.1038/srep35405CrossRefPubMedPubMedCentral

Nadeem R, Molnar J, Madbouly EM et al (2013) Serum inflammatory markers in obstructive sleep apnea: a meta-analysis. J Clin Sleep Med 9(10):1003–1012. https://doi.org/10.5664/jcsm.3070CrossRefPubMedPubMedCentral

Rocchi C., Conti V., Totaro V., Broggi S., Lattanzi S., Viticchi G., et al. (2021). Sex related differences in inflammation markers in adult patients with obstructive sleep apnea. WCN 2021 online. Meeting Abstracts ID 3506. doi.org/https://doi.org/10.1016/j.jns.2021.118667

Buysse DJ, Reynolds CF, Monk TH et al (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213. https://doi.org/10.1016/0165-1781(89)90047-4CrossRefPubMed

Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14:540–545. https://doi.org/10.1093/sleep/14.6.540CrossRefPubMed

10.

Ridker PM (2007) C-reactive protein and the prediction of cardiovascular events among those at intermediate risk: moving an inflammatory hypothesis toward consensus. J Am Coll Cardiol 49:2129–2138. https://doi.org/10.1016/j.jacc.2007.02.052CrossRefPubMed

11.

Gaines J, Vgontzas AN, Fernandez-Mendoza J, Kritikou I, Basta M, Bixler EO (2015) Gender differences in the association of sleep apnea and inflammation. Brain Behav Immun 47:211–217. https://doi.org/10.1016/j.bbi.2014.11.013CrossRefPubMed

12.

Li K, Wei P, Qin Y, Wei Y (2017) Is C-reactive protein a marker of obstructive sleep apnea?: a meta-analysis. Medicine (Baltimore) 96(19):e6850. https://doi.org/10.1097/MD.0000000000006850CrossRef

13.

Khera A, McGuire DK, Murphy SA, Stanek HG, Das SR, Vongpatansin W, Wians FH, Grundy SM, de Lemos JA (2005) Race and gender differences in C-reactive protein levels. J Am Coll Cardiol 46:464–469. https://doi.org/10.1016/j.jacc.2005.04.051CrossRefPubMed

14.

Doran B, Zhu W, Muennig P (2013) Gender differences in cardiovascular mortality by C- reactive protein level in the United States. Am Heart J 166:45–51. https://doi.org/10.1016/j.ahj.2013.03.017CrossRefPubMed

15.

Imani MM, Sadeghi M, Khazaie H, Emami M, Sadeghi Bahmani D, Brand S (2020) Evaluation of serum and plasma interleukin-6 levels in obstructive sleep apnea syndrome: a meta-analysis and meta-regression. Front Immunol 11:1343. https://doi.org/10.3389/fimmu.2020.01343CrossRefPubMedPubMedCentral

16.

Baessler A, Nadeem R, Harvey M, Madbouly E, Younus A, Sajid H, Naseem J, Asif A, Bawaadam H (2013) Treatment for sleep apnea by continuous positive airway pressure improves levels of inflammatory markers—a meta-analysis. J Inflamm (Lond) 10:13. https://doi.org/10.1186/1476-9255-10-13CrossRef

17.

Bonsignore MR, Saaresranta T, Riha RL (2019) Sex differences in obstructive sleep apnoea. Eur Respir Rev 28(154):190030. https://doi.org/10.1183/16000617.0030-2019CrossRefPubMed

18.

Hirotsu C, Albuquerque RG, Nogueira H, Hachul H, Bittencourt L, Tufik S, Andersen ML (2017) The relationship between sleep apnea, metabolic dysfunction, and inflammation: the gender influence. Brain Behav Immun 59:211–218. https://doi.org/10.1016/j.bbi.2016.09.005CrossRefPubMed

19.

Meier-Ewert HK, Ridker PM, Rifai N, Price N, Dinges DF, Mullington JM (2001) Absence of diurnal variation of C-reactive protein concentrations in healthy human subjects. Clin Chem 47:426–430CrossRefPubMed

20.

Bixler EO, Vgontzas AN, Lin HM, Ten Have T, Rein J, Vela-Bueno A et al (2001) Prevalence of sleep-disordered breathing in women: effects of gender. Am J Respir Crit Care Med 163(3 Pt 1):608–613. https://doi.org/10.1164/ajrccm.163.3.9911064CrossRefPubMed

21.

Tishler PV, Larkin EK, Schluchter MD, Redline S (2003) Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleep-disordered breathing. The Journal of the American Medical Association 289(17):2230–2237. https://doi.org/10.1001/jama.289.17.2230CrossRefPubMed

22.

Ley CJ, Lees B, Stevenson JC (1992) Sex- and menopause-associated changes in body-fat distribution. Am J Clin Nutr 55:950–954. https://doi.org/10.1093/ajcn/55.5.950CrossRefPubMed

23.

Zhang Z, Cheng J, Yang W, Zou H, Su C, Miao J (2020) Gender differences in clinical manifestations and polysomnographic findings in Chinese patients with obstructive sleep apnea. Sleep Breath 24(3):1019–1026. https://doi.org/10.1007/s11325-019-01943-yCrossRefPubMed

Titel: Inflammation markers in moderate and severe obstructive sleep apnea: the influence of sex
verfasst von: Chiara Rocchi
Conti Valentina
Viviana Totaro
Serena Broggi
Simona Lattanzi
Giovanna Viticchi
Lorenzo Falsetti
Mauro Silvestrini
Laura Buratti
Publikationsdatum: 06.01.2022
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 4/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-021-02537-3

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Inflammation markers in moderate and severe obstructive sleep apnea: the influence of sex