High Levels of Inflammation and Insulin Resistance in Obstructive Sleep Apnea Patients with Hypertension

Abstract

Hypertension induced by obstructive sleep apnea (OSA) may be multifactorial in origin, and systemic inflammation is one of the major factors. However, OSA patients do not always have the identical probability with hypertension even in patients with the same history and degree of OSA. The aim of this study was to compare the levels of inflammation and insulin resistance in two groups of patients who had the same degree as well as the same long history of OSA, but with/without hypertension. OSA patients (Apnea Hyponea Index, AHI ≥ 40/h, n = 70) were examined by polysomnography and blood analysis for the measurements of fasting plasma glucose, serum insulin (FINS), high-sensitivity C-reactive protein (CRP), peptide C,TNF-α, IL-6, and IL-10. Patients with hypertension (n = 40) had higher level of LDL-C and lower HDL-C levels than patients without hypertension. Almost half (16/40) of OSA patients with hypertension had family history of hypertension. Moreover in OSA patients with hypertension, the levels of TNF-α, IL-6, and CRP were higher, but IL-10 was lower than those without hypertension. FINS, peptide C, HOMA-IR, and HOMA-islet were also higher in OSA patients with hypertension. OSA patients with hypertension have higher level of inflammation and insulin resistance. Systemic inflammation and insulin resistance are both important factors for the development of hypertension in OSA patients.

Meta-analyses of the Association of Sleep Apnea with Insulin Resistance, and the Effects of CPAP on HOMA-IR, Adiponectin, and Visceral Adipose Fat

“…[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] Baseline characteristics of the study participants are detailed in Table 3. …”

Reduced Systemic Levels of IL‐10 Are Associated with the Severity of Obstructive Sleep Apnea and Insulin Resistance in Morbidly Obese Humans

“…Moreover, additional studies have also pointed out to other obesity-related metabolic abnormalities that may influence cytokine levels, as is the case of hypertension. Indeed, OSA patients with hypertension show reduced values of IL-10 accompanied by increased levels of TNF- α , IL-6, and CRP with respect to patients without high blood pressure [ 47 ]. Similarly, stroke patients with severe OSA exhibit increased levels of serum IL-6 when they also show hypertension [ 48 ].…”

The platelet-to-lymphocyte ratio reflects the severity of obstructive sleep apnea syndrome and concurrent hypertension

“…Systemic inflammation likely plays a major role in the development of hypertension in OSAS. A previous study showed that OSAS patients with hypertension had higher levels of inflammation and insulin resistance than do those without hypertension [ 30 ]. Since systemic inflammation plays an important role in hypertension in OSAS, PLR may have a role in the development of hypertension in OSAS patients.…”