Homocysteine level in patients
with obstructive sleep apnea/hypopnea syndrome
and the impact of continuous positive airway
pressure treatment

Li, Jie; Yu, Li-Qiang; Jiang, Min; Wang, Ling; Fang, Qi

doi:10.17219/acem/74178

Cited by 7 publications

(10 citation statements)

References 22 publications

(28 reference statements)

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“…In two studies, patients with mild disease displayed significantly higher MDA values when compared to those with severe form (mean difference range, −0.04 to −0.55) [39,49]. By contrast, in the remaining seven studies, the MDA value was found to be higher in patients with severe disease (mean difference range 0.63 to 1.65), with a significant difference in four studies [35,37,42,52]. The pooled results showed that MDA concentrations were significantly higher in patients with severe disease (SMD 0.59; 95% CI 0.05 to 1.12, p = 0.03; I 2 = 86.7%, p < 0.001) when compared with mild disease.…”

Section: Resultsmentioning

confidence: 86%

“…Conversely, age (t = −2.06, p = 0.049), assay type (t = 2.31, p = 0.03) and publication year (t = 2.08, p = 0.048) were significantly associated with the SMD. In order to evaluate the relationship between effect size and disease severity we performed a meta-analysis in a sub-group of nine studies reporting MDA concentrations in groups with different disease severity [32,35,37,38,42,45,47,49,52]. The forest plot for MDA concentrations in mild and severe OSA patients is reported in Figure 8.…”

Section: Resultsmentioning

confidence: 99%

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Circulating Malondialdehyde Concentrations in Obstructive Sleep Apnea (OSA): A Systematic Review and Meta-Analysis with Meta-Regression

Pau

Zinellu²,

Fois

et al. 2021

Antioxidants

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Oxidative stress induced by nocturnal intermittent hypoxia plays a significant pathophysiological role in obstructive sleep apnea (OSA). Malondialdehyde (MDA), one of the most commonly investigated markers of lipid peroxidation, might assist with the monitoring of oxidative balance in OSA. We conducted a systematic review and meta-analysis to evaluate the differences in circulating MDA concentrations between patients with OSA and non-OSA controls. A systematic search was conducted in the electronic databases Pubmed, Web of Science, Scopus and Google Scholar from inception to December 2020 by using the following terms: “malondialdehyde” or “MDA”; and “Obstructive Sleep Apnea Syndrome”, “OSAS” or “OSA”. We identified 26 studies in 1223 OSA patients and 716 controls. The pooled MDA concentrations were significantly higher in patients with OSA (standardized mean difference (SMD) 1.43 μmol/L, 95% confidence interval (CI) 1.03 to 1.83 μmol/L, p < 0.001). There was extreme heterogeneity between the studies (I2 = 92.3%, p < 0.001). In meta-regression analysis, the SMD was significantly associated with age, the assay type used and publication year. In our meta-analysis, MDA concentrations were significantly higher in OSA patients than in controls. This finding suggests that MDA, which is a marker of lipid peroxidation, is involved in the pathogenesis of OSA and provides insights for future studies investigating its potential clinical use.

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Section: Resultsmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Circulating Malondialdehyde Concentrations in Obstructive Sleep Apnea (OSA): A Systematic Review and Meta-Analysis with Meta-Regression

Pau

Zinellu²,

Fois

et al. 2021

Antioxidants

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show abstract

“…Though the homocysteine changes varied from study to study, substantial decreases were observed in most of them, which were recognized to be related to the improvements in sleep and desaturation-related indices. 18,32 This longitudinal cohort study aimed to evaluate the alterations of homocysteine levels in the severe OSA patients who received TORS-assisted upper airway surgery, and discovered the associations with the improvements in PSG parameters. We found that not only the majority of patients' PSG data improved generally, but the homocysteine level significantly decreased from 12.1 ± 3.9 to 11.4 ± 3.7 mcmol/L (difference = −0.7 ± 2.8 mcmol/L, p = .001) postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there are studies observing the changes in plasma homocysteine levels following CPAP or mandibular advancement device (MAD) therapy. [18][19][20][21] However, none of the studies discussed the alteration of homocysteine level in OSA patients treated with upper airway surgery.…”

mentioning

confidence: 99%

“…With the evidence [18][19][20] indicating that conservative OSA therapies could lower the OSA patients' homocysteine level, we hypothesized that the OSA patients receiving TORS may experience drop in homocysteine level to some extent as well, and expected the results would provide new insights in the future tasks of assessing the outcome value of TORS-OSA surgery. Therefore, we first evaluate the changes of homocysteine in severe OSA patients following TORS-assisted upper airway surgery.…”

mentioning

confidence: 99%

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Homocysteine Levels in Severe OSA Patients Before and After TORS‐OSA Surgery

Chiu

Lin

et al. 2023

Otolaryngol.--head neck surg.

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Objective The increased risk of cardiovascular diseases owing to a high level of serum homocysteine has been widely reported. Literature has demonstrated that patients with obstructive sleep apnea/hypopnea syndrome (OSA) had a higher homocysteine level than control group. This study aimed to investigate the alteration of serum homocysteine levels in severe OSA patients receiving transoral robotic surgery (TORS). Study Design Retrospective chart review. Setting Tertiary academic medical center. Methods Data of polysomnography (PSG) and serum homocysteine levels before and at least 3 months after the surgery were collected and analyzed via paired t tests. A subgroup analysis based on the preoperative homocysteine level (≥15 mcmol/L, as hyperhomocysteinemia group) was conducted to compare the intergroup differences of homocysteine decrease. Pearson's correlation was used to survey the relationships between the changes of major PSG parameters and the levels of homocysteine decrease at baseline and after TORS‐OSA surgery. Results Two hundred sixty‐one patients with severe OSA were enrolled. There were significant improvements in major PSG parameters after TORS‐OSA surgery. Homocysteine levels significantly decreased from 12.1 ± 3.9 to 11.4 ± 3.7 mcmol/L (difference = −0.7 ± 2.8 mcmol/L, p = .001) postoperatively, which was shown in the hyperhomocysteinemia group (difference = −2.9 ± 4.7 mcmol/L, p = .007) to a greater extent. Pearson's correlation revealed that ΔODI (oxygen desaturation index/h) was the predominant estimate with a positive association with Δhomocysteine (r = 0.525, p = .012). Conclusion TORS‐OSA surgery could decrease homocysteine levels in OSA patients. The effects were more relevant in severe OSA patients with abnormal preoperative homocysteine levels.

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Increased the circulating levels of malondialdehyde in patients with obstructive sleep apnea: a systematic review and meta-analysis

et al. 2021

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Homocysteine level in patients with obstructive sleep apnea/hypopnea syndrome and the impact of continuous positive airway pressure treatment

Abstract: The change of the Hcy level was not proportional to the severity of the disease in different groups of OSAHS patients, and CPAP did not affect the Hcy levels.

Cited by 7 publications

References 22 publications

Circulating Malondialdehyde Concentrations in Obstructive Sleep Apnea (OSA): A Systematic Review and Meta-Analysis with Meta-Regression

Circulating Malondialdehyde Concentrations in Obstructive Sleep Apnea (OSA): A Systematic Review and Meta-Analysis with Meta-Regression

Homocysteine Levels in Severe OSA Patients Before and After TORS‐OSA Surgery

Increased the circulating levels of malondialdehyde in patients with obstructive sleep apnea: a systematic review and meta-analysis

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