Vitamin D deficiency and interleukin-17 relationship in severe obstructive sleep apnea–hypopnea syndrome

Abstract

PURPOSE:We aimed to assess Vitamin D (VD) abnormalities in patients with severe obstructive sleep apnea–hypopnea syndrome (OSAHS), to study its association with clinical and polygraphic data, and to correlate VD levels with interleukin-17 (IL-17).METHODS:Ninety-two patients with severe OSAHS were consecutively enrolled between September 2014 and February 2016 and compared to age-, sex-, and body mass index (BMI)-matched controls. Anthropometric parameters and medical history were collected. The serum levels of VD and IL-17 were determined by radioimmunoassay and enzyme-linked immunosorbent assay, respectively.RESULTS:Ninety-two severe OSAHS patients and thirty controls were enrolled in the study. All OSAHS patients had VD deficiency. The mean level of VD was at 7.9 ng/ml among OSAHS group versus 16.8 ng/ml among control group. IL-17A levels were elevated (20.3 pg/ml) in OSAHS group compared to healthy group (10.05 pg/ml). VD levels were negatively correlated with nocturia severity (r = −0.26; P = 0.01) and positively correlated with mean O2 saturation (r = 0.59; P = 0.02) and lowest O2 saturation (r = 0.3; P = 0.03). IL-17 levels were positively correlated with nocturia severity (r = 0.24; P = 0.03) and negatively correlated with mean O2 saturation (r = −0.42; P = 0.03). A significant negative association was observed between IL-7 and VD levels (r = −0.64, P = 0.2 10−4). The magnitude of this correlation was higher for important nocturia, lower MSaO2, or higher BMI.CONCLUSIONS:VD deficiency in patients with severe OSAHS is common with a negative association between IL-17 and VD serum levels. Hypoxia could play an important role in this association. Further studies are needed to clarify this relationship.

The Association between Vitamin D Deficiency and Sleep Disorders: A Systematic Review and Meta-Analysis

“…VDR are widely distributed in human brain, such as the hypothalamus, prefrontal cortex, midbrain central gray, substantia nigra, and raphe nuclei, all of which are known to execute important roles in sleep regulation [ 42 , 43 ]. VDD [ 44 ] is a prevalent condition that is associated with a deforming demineralization of bones, as well as more recent problems such as chronic nonspecific pain [ 45 , 46 , 47 , 48 , 49 , 50 ], which may cause poor sleep [ 51 , 52 ]. Chronic, nonspecific clinical pain seems to be a marker of VDD: The prevalence of VDD was high in patients who complained about intractable pain of an uncertain cause.…”

Changes of vitamin D levels and bone turnover markers after CPAP therapy: a randomized sham‐controlled trial

“…Previous studies have primarily assessed vitamin D levels in patients with OSA (Archontogeorgis et al ., ; Barcelo et al ., ; Erden et al ., ; Kerley et al ., , ; Mete et al ., ; Salepci et al ., ; Toujani et al ., ), whereas markers of bone turnover have not been studied extensively in this patient group (Terzi and Yilmaz, ). Barcelo et al .…”

“…Recent evidence has identified a link between OSA and vitamin D deficiency (Archontogeorgis et al ., ; Barcelo et al ., ; Bozkurt et al ., ; Erden et al ., ; Mete et al ., ; Salepci et al ., ; Toujani et al ., ), as well as shown potential associations between OSA and osteoporosis (Upala et al ., ). Furthermore, the bone turnover markers osteocalcin and β ‐CTx have also been shown to be reduced in OSA compared with controls (Terzi and Yilmaz, ; Tomiyama et al ., ).…”

A meta‐analysis: Does vitamin D play a promising role in sleep disorders?

“…The detailed outcomes are presented in Table 2, Table 3, Table S1, and Table S2. Celik et al, 2015;Cikrikcioglu et al, 2016;Erden et al, 2014;Gunduz et al, 2016;Huzmeli, 2018;Mete et al, 2013;Pazarli et al, 2019;Terzi & Yilmaz, 2016;Uygur et al, 2016), 3 studies were performed in Europe (Kerley et al, 2016;Liguori et al, 2015;Zicari et al, 2016), and 5 studies were performed in Asia (Gong et al, 2018;Han et al, 2017;Qiao et al, 2018;Wali et al, 2018;Zhao et al, 2017) (the America group and Africa group were not analyzed because only 1 paper was included, respectively (Neves et al, 2017;Toujani et al, 2017)). Seven studies used EI to analyze the vitamin D levels (Balaban et al, 2012;Celik et al, 2015;Cikrikcioglu et al, 2016;Gong et al, 2018;Mete et al, 2013;Qiao et al, 2018;Zhao et al, 2017), and 6 studies used CI (Erden et al, 2014;Kerley et al, 2016;Neves et al, 2017;Pazarli et al, 2019;Uygur et al, 2016;Zicari et al, 2016),…”

“…while the remaining studies (Bozkurt et al, 2012;Gunduz et al, 2016;Terzi & Yilmaz, 2016;Toujani et al, 2017) (n = 4)used other methods…”