Obstructive Sleep Apnea Assessed by Overnight Polysomnography in Patients With Keratoconus

Pedrotti, Emilio; Demasi, Christian Luigi; Fasolo, Adriano; Bonacci, Erika; Brighenti, Tommaso; Gennaro, Nicola; Ferrari, Marcello; Marchini, Giorgio

doi:10.1097/ico.0000000000001509

Cited by 20 publications

(13 citation statements)

References 28 publications

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“…We have shown that KC remains stable over 12 months in patients supplemented with Vit D. KC has been traditionally considered an isolated ocular disease, whereas recent evidence suggests that KC is, in fact, a manifestation of a systemic disorder. Indeed, it is known that 21% to 70% of KC patients present a concomitant systemic disease, such as atopy, 41 , 42 sleep apnea, 43 mitral valve prolapse, 44 , 45 hypothyroidism, 46 or Down syndrome. 47 , 48 Interestingly, many of these diseases are associated with Vit D insufficiency.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Supplementation Impacts Systemic Biomarkers of Collagen Degradation and Copper Metabolism in Patients With Keratoconus

Vitar

Fonteyne

Knutsson

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose To evaluate the impact of vitamin D (Vit D) supplementation on systemic biomarkers of collagen degradation, inflammation, oxidative stress, and copper metabolism in adolescent patients with keratoconus (KC). Methods This was a prospective observational pilot study. Twenty patients (age range, 16–19 years) presenting KC and Vit D insufficiency (<30 ng/mL) were included. Vit D supplementation was prescribed by their general practitioner as per the standard of care. Patients were followed up for 12 months. At each visit, best spectacle-corrected visual acuity (BSCVA), maximal keratometry (Kmax), and thinnest corneal thickness (TCT) were evaluated. The primary outcome of the study was the proportion of patients with Kmax progression of less than 1 D throughout the 12-month follow-up time. Blood samples were collected at different time points to evaluate Vit D levels and systemic markers of collagen degradation, inflammation, oxidative stress, and copper metabolism by ELISA or RT-PCR. Results Lower Vit D levels in the plasma were correlated with higher levels of systemic biomarkers of collagen degradation. Vit D supplementation increased the cell availability of copper. Moreover, stabilization of KC progression was found in 60% of patients (72% of eyes) after 12 months with Vit D supplementation. BSCVA, Kmax, and TCT rates remained stable during the observation period. Conclusions Our findings support that Vit D administration could affect ocular and systemic biomarkers in KC and illuminate a possible mechanism that can be used to develop new treatment alternatives. Translational Relevance Although KC therapy currently relies exclusively on surgical procedures, Vit D supplementation may offer a non-invasive and inexpensive alternative with minimal associated side effects.

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Section: Discussionmentioning

confidence: 99%

Vitamin D Supplementation Impacts Systemic Biomarkers of Collagen Degradation and Copper Metabolism in Patients With Keratoconus

Vitar

Fonteyne

Knutsson

et al. 2022

Trans. Vis. Sci. Tech.

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“…The association between increasing NC and increased risk of developing obstructive sleep apnea has been well documented in the literature. [21][22][23] Additionally, OSA has been associated with increased risk of incident HF. [24] Additional research on potential mechanisms of the association between NC and HF is needed.…”

Section: Discussionmentioning

confidence: 99%

Neck circumference and cardiovascular outcomes: Insights from the Jackson Heart Study

Pumill¹,

Bush²,

Greiner³

et al. 2019

American Heart Journal

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Background: Emerging data suggest that neck circumference (NC) is associated with cardiometabolic risk factors. Limited research is available regarding the association between NC and cardiovascular outcomes in African Americans. Methods: Using data from the Jackson Heart Study, we included participants with recorded NC measurements at baseline (2000-2004). Baseline characteristics for the included population were summarized by tertiles of NC. We then calculated age-and sex-adjusted cumulative incidence of clinical cardiovascular outcomes and performed Cox proportional hazards with stepwise models. Results: Overall, 5290 participants were categorized into tertiles of baseline NC defined as ≤37 cm (N=2179), 38-40 cm (N=1552), and >40 cm (N=1559). After adjusting for age and sex, increasing NC was associated with increased risk of heart failure (HF) hospitalization (cumulative incidence = 13.4% [99% CI, 10.7-16.7] in the largest NC tertile vs. 6.5% [99% CI, 4.7-8.8] in the smallest NC tertile), but not mortality, stroke, myocardial infarction or coronary heart disease (all P≥0.1). Following full risk adjustment, there was a nominal increase in the risk of HF hospitalization with increasing NC, but this was not statistically significant (hazard ratio per 1-cm increase, 1.04 [99% CI, 0.99-1.10], P=0.06).

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“…In fact, there is no clinical evidence of associated systemic diseases. There are, however, some exceptions; atopy [13], sleep apnea [14], mitral valve prolapse [15,16], hypothyroidism [17], and Down's syndrome [18,19] have been detected in a percentage of KC patients varying from 21% to 70%. It is interesting to note that many of these diseases cause metabolic [20][21][22] and/or nutritional [22,23] imbalance.…”

Section: Introductionmentioning

confidence: 99%

Nutritional and Metabolic Imbalance in Keratoconus

et al. 2022

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Keratoconus (KC) is a progressive corneal degeneration characterized by structural changes consisting of progressive thinning and steepening of the cornea. These alterations result in biomechanical weakening and, clinically, in vision loss. While the etiology of KC has been the object of study for over a century, no single agent has been found. Recent reviews suggest that KC is a multifactorial disease that is associated with a wide variety of genetic and environmental factors. While KC is typically considered a disease of the cornea, associations with systemic conditions have been well described over the years. In particular, nutritional and metabolic imbalance, such as the redox status, hormones, metabolites, and micronutrients (vitamins and metal ions), can deeply influence KC initiation and progression. In this paper, we comprehensively review the different nutritional (vitamins and minerals) and metabolic (hormones and metabolites) factors that are altered in KC, discussing their possible implication in the pathophysiology of the disease.

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Obstructive Sleep Apnea Assessed by Overnight Polysomnography in Patients With Keratoconus

Cited by 20 publications

References 28 publications

Vitamin D Supplementation Impacts Systemic Biomarkers of Collagen Degradation and Copper Metabolism in Patients With Keratoconus

Vitamin D Supplementation Impacts Systemic Biomarkers of Collagen Degradation and Copper Metabolism in Patients With Keratoconus

Neck circumference and cardiovascular outcomes: Insights from the Jackson Heart Study

Nutritional and Metabolic Imbalance in Keratoconus

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