Putative associations between inflammatory biomarkers, obesity, and obstructive sleep apnea
Siraj Omar Wali1, Md Dilshad Manzar2, Mohammed M Abdelaziz3, Ranya Alshomrani1, Faris Alhejaili1, Jamil Al-Mughales4, Wail Alamoudi5, David Gozal6
1 Department of Internal Medicine, Faculty of Medicine, Sleep Medicine and Research Center, Sleep Medicine Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
2 Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
3 Department of Medicine, Wythenshawe Hospital, Manchester University NHS Trust, Manchester, UK
4 Department of Clinical Laboratory Medicine, Immunology Lab, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
5 Department of Medicine, King Abdulaziz University – Rabigh Branch, Rabigh, Saudi Arabia
6 Department of Child Health, Child Health Research Institute, The University of Missouri School of Medicine, Columbia, MO, USA
Prof. Siraj Omar Wali
College of Medicine, King Abdulaziz University, Jeddah 80215, Saudi Arabia. Sleep Medicine and Research Center, King Abdulaziz University Hospital, PO Box: 21589, Jeddah 80215
BACKGROUND: Previous studies have reported increased levels of inflammatory mediators in patients with obstructive sleep apnea (OSA), but their relation with the severity of OSA is controversial.
OBJECTIVE: To address potential relationships between OSA-related inflammatory markers, namely, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and fibrinogen, with different oxygenation parameters and with BMI.
METHODS: All eligible patients with suspected OSA newly referred to the Sleep Medicine Research Center at King Abdulaziz University Hospital, Jeddah, were evaluated demographically and anthropometrically, and underwent overnight polysomnography. Fasting morning blood samples were collected to measure serum levels of CRP, fibrinogen, TNF-α, and IL-6. Potential correlations between these inflammatory mediators and severity measures of OSA and body mass index (BMI) were explored.
RESULTS: Sixty-four patients completed the study (40 with OSA and 24 without OSA). Significantly increased levels of CRP, fibrinogen, IL-6, and TNF-α emerged in patients with OSA compared to non-OSA. Significant associations between log CRP and log fibrinogen levels emerged with increasing BMI. However, there was no significant association between any of the inflammatory markers and the severity of OSA based on the apnea/hypopnea index or oxyhemoglobin saturation-derived parameters.
CONCLUSIONS: OSA patients exhibit increased levels of inflammatory mediators that do not appear to be associated with polysomnographic measures, but exhibit positive correlation with the degree of adiposity.