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Endothelial dysfunction and C-reactive protein in relation with the severity of obstructive sleep apnea syndrome
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- Authors
- Issue Date
- 2007-08-19
- Publisher
- American Academy of Sleep Medicine
- Citation
- Sleep. 2007;30(8):997-1001
- Keywords
- Adult ; Anoxia/blood/diagnosis ; Body Mass Index ; C-Reactive Protein/*metabolism ; Endothelium, Vascular/*physiopathology ; Female ; Humans ; Male ; Middle Aged ; Obesity/blood ; Oxygen/blood ; Risk Factors ; Sleep Apnea, Obstructive/*blood/diagnosis ; Vasodilation/physiology ; Waist-Hip Ratio ; Polysomnography
- Abstract
- STUDY OBJECTIVES: To investigate flow-mediated dilatation (FMD) and C-reactive protein (CRP) levels in patients with obstructive sleep apnea syndrome (OSAS) in relation with the severity of respiratory disturbances and hypoxemia. DESIGN: After subjects had completed nocturnal polysomnography, FMD was measured in the brachial artery, and blood samples were obtained to determine serum CRP levels. SETTING: Sleep laboratory in Seoul National University Bundang Hospital. PATIENTS: Ninety men: 22 normal controls, 28 subjects with mild to moderate OSAS, and 40 with severe OSAS. MEASUREMENTS AND RESULTS: FMD was found to be correlated with oxygen desaturation index (ODI), percentage of time below 90% O2 saturation, average O2 saturation, lowest O2 saturation, systolic blood pressure, apnea hypopnea index (AHI), and body mass index. In addition, CRP was correlated with body mass index, waist-to-hip ratio, neck circumference, diastolic pressure, average O2 saturation and percentage of time below 90% O2 saturation but not with AHI. Stepwise multiple regression showed that the ODI was a significant determinant of FMD (adjusted R2 = 10%, beta = -0.33, P < 0.01). In addition, body mass index (beta = 0.25, P < 0.05) and waist-to-hip ratio (beta = 0.21, P < 0.05) were found to be significantly correlated with CRP (adjusted R2 = 12%, P < 0.05), independently of other factors. There was no correlation between FMD and CRP. CONCLUSION: As a marker of nocturnal hypoxemia, ODI rather than AHI might better explain the relationship between OSAS and FMD. Because body mass index and waist-to-hip ratio were identified as risk factors of high serum CRP in OSAS, obesity should be considered when predicting cardiovascular complications in OSAS.
- ISSN
- 0161-8105 (Print)
- Language
- English
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