肺疾患と治療のジャーナル

A Narrative Review of Obstructive Sleep Apnea in Relation to the Associated Biomarkers and the Impact of CPAP Treatment on them

Abstract

Protas M, Dana O, Diyar O, Murray IJV, Ogedegbe C and Ashtyani H

Obstructive sleep apnea (OSA) is a sleep disorder characterized by intermittent cessations of breathing due to obstruction of the upper respiratory tract. Obesity and OSA often coexist and obesity may be a major risk factor for worsening OSA. Both are associated with several comorbidities such as hypertension, cardiovascular disease and cerebrovascular accidents. There are biomarkers that are shared between both obesity and OSA with some being more sensitive for OSA. To better understand the relationship of the biomarkers associated specifically with OSA, a more comprehensive review of OSA biomarkers compared to previous literature was conducted with the goal of determining whether OSA is an individual risk factor. Specifically, OSA patients were matched based on BMI to controls with no comorbidities to rule out confounders. Furthermore, it was investigated if continuous positive airway pressure (CPAP) therapy was effective in reducing these biomarkers. OSA was shown to be an individual associated risk factor, compared to obesity, for further changes in biomarkers related to inflammatory changes (Il-8, TNF- a, IL-6, INF-y), epithelial and cellular receptor regulation (ICAM-1, VCAM-1, P-Selectin, TLR-2 and TLR-4), atherosclerosis biomarkers and anatomical changes (increased CIMT, pulse wave velocity, catecholamines, aortic pulse velocity index), diabetes (HbA1c, insulin resistance) and hypertension (sFLT-1, sEng, YKL-40). This review revealed that biomarkers are significantly associated with OSA independent from obesity. CPAP treatment resulted in a reduction of these biomarkers.