Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil.
School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada.
J Clin Sleep Med. 2015 Jan 15;11(1):27-36. doi: 10.5664/jcsm.4358.
The purpose of this systematic review is to evaluate the diagnostic value of biological markers (exhaled breath condensate, blood, salivary and urinary) in the diagnosis of OSA in comparison to the gold standard of nocturnal PSG.
Studies that differentiated OSA from controls based on PSG results, without age restriction, were eligible for inclusion. The sample of selected studies could include studies in obese patients and with known cardiac disease. A detailed individual search strategy for each of the following bibliographic databases was developed: Cochrane, EMBASE, MEDLINE, PubMed, and LILACS. The references cited in these articles were also crosschecked and a partial grey literature search was undertaken using Google Scholar. The methodology of selected studies was evaluated using the 14-item Quality Assessment Tool for Diagnostic Accuracy Studies.
After a two-step selection process, nine articles were identified and subjected to qualitative and quantitative analyses. Among them, only one study conducted in children and one in adults found biomarkers that exhibit sufficiently satisfactory diagnostic accuracy that enables application as a diagnostic method for OSA.
Kallikrein-1, uromodulin, urocotin-3, and orosomucoid-1 when combined have enough accuracy to be an OSA diagnostic test in children. IL-6 and IL-10 plasma levels have potential to be good biomarkers in identifying or excluding the presence of OSA in adults.
本系统评价旨在评估生物标志物(呼出气冷凝物、血液、唾液和尿液)在诊断 OSA 方面的诊断价值,并与 PSG 这一金标准进行比较。
本研究纳入了无年龄限制、基于 PSG 结果对 OSA 与对照组进行区分的研究。所选研究的样本可包括肥胖患者和已知患有心脏病的患者。针对以下每个文献数据库,我们都制定了详细的个体搜索策略:Cochrane、EMBASE、MEDLINE、PubMed 和 LILACS。还交叉核对了这些文章中的参考文献,并使用 Google Scholar 进行了部分灰色文献搜索。使用 14 项诊断准确性研究质量评估工具对选定研究的方法进行了评估。
经过两步筛选过程,共确定了 9 篇文章,并对其进行了定性和定量分析。其中,只有一项在儿童中进行的研究和一项在成人中进行的研究发现了具有足够满意诊断准确性的生物标志物,使其能够作为 OSA 的诊断方法应用。
在儿童中,激肽释放酶 1、尿调蛋白、尿促生素 3 和乳球蛋白 1 联合应用具有足够的准确性,可作为 OSA 的诊断试验。在成人中,IL-6 和 IL-10 血浆水平可能具有成为识别或排除 OSA 存在的良好生物标志物的潜力。