Serum Cardiotrophin-1 and IL-6 Levels in Patients with Obstructive Sleep Apnea Syndrome
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Serum Cardiotrophin-1 and IL-6 Levels in Patients with Obstructive Sleep Apnea Syndrome Ozlem Kar Kurt,1,3 Mehmet Tosun,2 and Fahrettin Talay1
Abstract—Obstructive sleep apnea syndrome (OSAS) is associated with increased rates of cardiovascular diseases (CVD). Basic mechanisms involved in the increased cardiovascular risk of OSAS remain unclear. Inflammation has been shown to potentially play a critical role in this association. The aim of the present study was to investigate the level of cardiotrophin-1 (CT-1) in patients with OSAS. Forty-eight newly diagnosed OSAS patients and 37 nonapneic controls were enrolled in this study. Demographic data, cigarette smoking status, previous history of chronic diseases including CVD and metabolic diseases and drugs, and habits were obtained by a standardized questionnaire. All patients underwent polysomnographic evaluation. The mean age was 48.3±12.3 (24–74) years in OSAS group. Median apnea–hypopnea index was 23.6 (6–91.8) and median body mass index was 30.4 (24.2–49.4) in the OSAS group. Plasma CT-1 levels in OSAS and control groups, respectively, were 12.03±1.08 and 11.85±1.18 pg/ml. There was no significant difference in the plasma levels of CT-1 and IL-6 between the OSAS group and the controls. KEY WORDS: cardiotrophin-1; interleukin-6; obstructive sleep apnea syndrome; inflammation.
INTRODUCTION Obstructive sleep apnea syndrome (OSAS) is a widespread disorder characterized by recurrent episodes of total or partial upper airway obstruction during sleep with associated drops in arterial oxygen saturation and arousals from sleep which lead to excessive daytime sleepiness and causes other diurnal symptoms [1]. OSAS is known to be associated with cardiovascular morbidity and mortality. Previous studies have demonstrated that OSAS is independently associated with a number of cardiovascular diseases, such as hypertension, ischemic heart disease, stroke, heart failure, atrial fibrillation and cardiac sudden death [2–4]. The independent association of OSAS with cardiovascular disease (CVD) is particularly strong for systemic hypertension, but the association of OSAS with other CVDs remains unclear [2–4]. Several mechanisms are likely to be involved, including repetitive
arousals, rises in catecholamines, and sympathetic overactivity. Hypercoagulability and inflammation were found to be associated with OSAS and coronary artery disease [5, 6]. One possible link between OSAS and CVD is that the oxidative stress that occurs due to hypoxia leads to an inflammatory state [7]. Cardiotrophin-1 (CT-1) is a member of the interleukin6 (IL-6) family, described as an active inducer of cardiac hypertrophy, atherosclerosis, congestive heart failure, hypertension, valvular heart disease, acute coronary syndrome, and cardiomyopathies [8–12]. On the other hand, its beneficial properties have also been described for the liver, kidney, and neuromuscular tissue [13–15]. In the present study, we aimed to investigate the correlation between plasma CT-1 and IL-6 levels with the severity of OSAS defined by apn
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