Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Sleep Breath. 2020 Sep;24(3):809-815. doi: 10.1007/s11325-020-02089-y. Epub 2020 May 12.
Obstructive sleep apnea (OSA) is associated with an increased risk of developing atherosclerotic cardiovascular disease (ASCVD). Patients with OSA have increased levels of oxidative stress and several studies have shown higher levels of oxidative stress markers. Oxidized-LDL (Ox-LDL) is an important risk factor for ASCVD and a number of studies have measured its levels in patients with OSA, though results from these studies are conflicting. This meta-analysis aimed to reassess circulating levels of Ox-LDL in patients with OSA in comparison with controls.
Studies evaluating Ox-LDL levels in patients with OSA and controls were explored in databases of PubMed, EMBASE, Scopus, and Web of Science. Two authors independently performed the search from January 1990 to February 2019. Two authors independently screened the studies according to title, abstract, and full text. In addition, the Newcastle-Ottawa Quality Assessment Scale was utilized to evaluate the quality of the studies. The impact of OSA on Ox-LDL levels was determined using the random effects model.
Of 195 articles retrieved, 98 were duplicates, 49 were excluded by title, 20 excluded by abstract, and 22 by full texts. Six eligible studies were included in the meta-analysis. Pooled analysis demonstrated that Ox-LDL increased in patients with OSA compared with controls. In addition, subgroup analysis revealed that studies matching age or BMI between OSA patients and controls showed no significant difference between patients with OSA and healthy controls, while unmatched studies had higher levels of Ox-LDL in patients with OSA in comparison with controls.
This study demonstrated higher circulating concentrations of Ox-LDL in patients with OSA. However, no significant difference was found in studies in which patients and controls were matched for age and BMI, suggesting the involvement of these two confounding factors as a cause for elevated concentrations of circulating Ox-LDL in patients with OSA.
阻塞性睡眠呼吸暂停（OSA）与动脉粥样硬化性心血管疾病（ASCVD）的发病风险增加有关。OSA 患者氧化应激水平升高，多项研究表明氧化应激标志物水平升高。氧化型低密度脂蛋白（Ox-LDL）是 ASCVD 的重要危险因素，多项研究测量了 OSA 患者的 Ox-LDL 水平，但这些研究的结果存在争议。本荟萃分析旨在重新评估 OSA 患者与对照组相比循环 Ox-LDL 水平。
在 PubMed、EMBASE、Scopus 和 Web of Science 数据库中搜索评估 OSA 患者 Ox-LDL 水平的研究。两名作者独立从 1990 年 1 月至 2019 年 2 月进行搜索。两名作者独立根据标题、摘要和全文筛选研究。此外，还使用纽卡斯尔-渥太华质量评估量表评估研究质量。使用随机效应模型确定 OSA 对 Ox-LDL 水平的影响。
在检索到的 195 篇文章中，98 篇是重复的，49 篇根据标题被排除，20 篇根据摘要被排除，22 篇根据全文被排除。有 6 项符合条件的研究纳入荟萃分析。汇总分析表明，与对照组相比，OSA 患者的 Ox-LDL 水平升高。此外，亚组分析表明，在 OSA 患者和对照组之间匹配年龄或 BMI 的研究中，OSA 患者与健康对照组之间没有显著差异，而不匹配的研究中，OSA 患者的 Ox-LDL 水平明显高于对照组。
本研究表明 OSA 患者循环 Ox-LDL 浓度升高。然而，在患者和对照组匹配年龄和 BMI 的研究中未发现显著差异，提示这两个混杂因素可能是 OSA 患者循环 Ox-LDL 浓度升高的原因。
