Correlation between Inflammatory Markers of Atherosclerosis and Carotid Intima-Media Thickness in Obstructive  Sleep Apnea

Ciccone, Marco Matteo; Scicchitano, Pietro; Zito, Annapaola; Cortese, Francesca; Boninfante, Barbara; Falcone, Vito Antonio; Quaranta, Vitaliano Nicola; Ventura, Valentina Anna; Zucano, Antonietta; Serio, Francesca Di; Damiani, Mario Francesco; Resta, Onofrio

doi:10.3390/molecules19021651

Cited by 96 publications

(90 citation statements)

References 54 publications

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“…In one study of 102 Turkish patients [22], the walls of the CCA were thicker and the intima-media thickening ratios were higher in patients with severe OSAHS than in patients with mild-moderate OSAHS. Ciccone et al [23] found, in a study of 80 Italian patients, that the carotid IMT was higher in OSAHS patients than in control subjects, and that moderate-severe OSAHS patients had a significantly higher carotid IMT than patients with mild OSAHS. Fox et al reported that Canadian OSAHS patients, who did not have a history of additional risk factors for cardiovascular disease, had a higher carotid IMT than individuals in a BMI-, age-and gender-matched community-based cohort [24].…”

Section: Discussionmentioning

confidence: 99%

Effect of obstructive sleep apnea on carotid artery intima media thickness related to inflammation

Kong

Qin

Wang

et al. 2017

CIM

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Effect of obstructive sleep apnea on carotid artery intima media thickness related to inflammation Abstract Purpose: Obstructive sleep apnea hypopnea syndrome (OSAHS) is an independent risk factor for atherosclerosis. To ascertain the effect of OSAHS on the development of atherosclerosis in Chinese OSAHS patients, we evaluated markers of atherosclerosis as well as vascular endothelial function and inflammation.Methods: Chinese men with polysomnography-diagnosed OSAHS were subgrouped into mild-moderate (n = 28) and severe (n = 54) OSAHS groups on the basis of apnea hypopnea index (AHI) scores. The control group was made up of 30 healthy men. Atherosclerosis was assessed by carotid artery intima-media thickness (IMT) of both sides, flow-mediated dilation (FMD), and inflammation by interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), vascular endothelial growth factor (VEGF), and monocyte chemoattractant protein-1 (MCP-1) levels.Results: Linear regression analysis was used to identify significant associations among risk factors and carotid IMT. The following parameters were significantly higher in patients with severe OSAHS than in the control group: waking triglycerides, total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, blood uric acid, blood glucose, IL-6 and hs-CRP. FMD in severe OSAHS patients was lower than in the control group. AHI score, waking hs-CRP, waking oxidized low-density lipoprotein, blood glucose, and vascular endothelial growth factor (VEGF) level were positively associated with IMT. Conclusions:In Chinese male patients with severe OSAHS, the significantly higher carotid IMT and levels of inflammatory factors (IL-6 and hs-CRP) and lower FMD suggest that arterial endothelial damage and inflammation may play important roles in the development of atherosclerosis in OSAHS patients. Patients with the most common sleep disorder, obstructive sleep apnea hypopnea syndrome (OSAHS), experience repeated occurrences of airflow cessation (apnea) and reduction (hypopnea) during sleep [1]. The prevalence of OSAHS is between 2% and 10% worldwide [2]. In China, OSAHS has been shown to affect 3.63% of people older than 30 years [3,4]. Increasing evidence suggests that OSAHS is an independent risk factor for hypertension, coronary heart disease and stroke [5][6][7]. Because atherosclerosis has a pathophysiological basis in cardiovascular disease, it is important to understand how OSAHS and atherosclerosis may be related [8,9]. Various studies have shown that an increase of intima-media thickness (IMT) of the common carotid artery (CCA) is an early marker of cardiovascular risk [10,11]. Increased IMT is also a characteristic of patients with OSAHS [12,13]. OSAHS and atherosclerosis share the same risk factors: advanced age, gender, overweight, alcohol consumption and smoking [1][2][3][4][5][6]. In addition, the intermittent hypoxia experienced in OSAHS induces oxidative stress, inflammation and endothelial damage, which are related to a higher risk of atherosclerosis [14][15][16...

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Section: Discussionmentioning

confidence: 99%

Effect of obstructive sleep apnea on carotid artery intima media thickness related to inflammation

Kong

Qin

Wang

et al. 2017

CIM

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“…[29][30][31] CPAP is currently the most effective treatment for reducing associated CVD risks, including blood pressure, atherosclerotic manifestations, [32][33][34] and mortality, 15 in male subjects. The elderly have higher cardiovascular mortality rates, but CPAP may reduce this risk.…”

Section: Discussionmentioning

confidence: 99%

All-cause mortality from obstructive sleep apnea in male and female patients with and without continuous positive airway pressure treatment: A registry study with 10 years of follow-up

Jennum

Tønnesen

Ibsen³

et al. 2015

Sleep Medicine

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Background: More information is needed about the effect on mortality of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA), especially in women. Methods:We employed a historical cohort study design, using data from 25,389 patients with a diagnosis of OSA selected from the Danish National Patient Registry for the period 1999-2009. We used Cox proportional hazard function to evaluate the all-cause mortality from OSA in middle-aged and elderly males and females who were treated, or not, with CPAP. Results: Female OSA patients had a lower mortality than males, irrespective of whether they received CPAP treatment. CPAP treatment improved survival, as illustrated by the hazard ratio of 0.62 (P,0.001). This effect was dependent on gender: CPAP had no significant effect on 20-to 39-year-old males and females, but the overall mortality in this age group was small. Survival was increased by CPAP in 40-to 59-year-old and $60-year-old males, but no such effect was observed in females. Positive predictors of survival were young age, female gender, higher educational level, and low 3-year prior comorbidity as estimated by the Charlson Comorbidity Index. Negative predictors for survival were male gender, age $60 years, no CPAP treatment, prior comorbidity, and low educational level. Conclusion: CPAP therapy is associated with reduced all-cause mortality in middle-aged and elderly males, but no significant effect was found in females.

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“…The reference value of CRP is <3 mg/L. (25) Angiography is the gold standard for determining the degree of coronary stenosis. The finding of minimal stenosis in one coronary artery, expressed as 0% stenosis, indicates a normal coronary without stenosis.…”

Section: Study Subjectsmentioning

confidence: 99%

Blood viscosity increases the degree of coronary stenosis in coronary heart disease

Indrianto

Samsuria

Kurniawan

2016

UnivMed

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BACKGROUNDEndothelial dysfunction and associated increased blood viscosity (BV) play an important role in the formation of atherosclerosis during inflammatory processes. C-reactive protein (CRP) is a biomarker of inflammation with an active role in endothelial dysfunction and development of atherosclerosis that is marked by degree of coronary stenosis (CS). The purpose of this study was to determine the relationship of BV and CRP with varying degrees of CS among coronary heart disease (CHD) patients. METHODSThis cross-sectional study involved 24 subjects taken consecutively among patients with CHD who underwent angiography. Blood viscosity levels were determined using an Ostwald viscometer, with reference limits of 1.5 to 1.72 (cP). C-reactive protein was determined by turbidimetric immunoassay, with a normal reference value of <3 mg/L. Degree of CS was examined with angiography, where 0% = no stenosis; <50% = nonsignificant stenosis; > 50% = significant stenosis. Data was analyzed using non-parametric Spearman correlation test. RESULTSThere were 17 male and 7 female subjects, with mean age of 55.96 ± 7.29 years. The angiography results were: non-significant stenosis in 2 subjects (8.3%), significant stenosis in 22 subjects (91.7%) and none with normal stenosis. Statistical analysis of the relationship of BV with degree of CS found a moderate significant positive relationship (r=0.549; p=0.005). A poor significant positive relationship was found between CRP and degree of CS (r=0.481; p=0.017). CONCLUSIONBlood viscosity increased the degree of CS in CHD patients. Therapy should target both BV-associated risk and angiographically evident stenosis. Keywords

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Correlation between Inflammatory Markers of Atherosclerosis and Carotid Intima-Media Thickness in Obstructive Sleep Apnea

Cited by 96 publications

References 54 publications

Effect of obstructive sleep apnea on carotid artery intima media thickness related to inflammation

Effect of obstructive sleep apnea on carotid artery intima media thickness related to inflammation

All-cause mortality from obstructive sleep apnea in male and female patients with and without continuous positive airway pressure treatment: A registry study with 10 years of follow-up

Blood viscosity increases the degree of coronary stenosis in coronary heart disease

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