Saruhan Ercan, Sertoglu Erdim, Unal Yasemin, Bek Semai, Kutlu Gulnihal
Department of Biochemistry, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.
Department of Biochemistry, Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey.
Sleep Breath. 2021 Jun;25(2):923-930. doi: 10.1007/s11325-020-02207-w. Epub 2020 Oct 8.
Obstructive sleep apnea (OSA) is a disorder characterized by recurrent episodes of obstruction of the upper respiratory tract during sleep often accompanied by oxygen desaturations. Antioxidant defense mechanisms are important to prevent OSA-associated diseases and decrease mortality. We aimed to determine the levels of selenium and vitamins A, C, and E in patients with OSA but without any comorbidities and compare the results with a control group, theorizing that the findings may be helpful to understand the antioxidant mechanisms in the pathogenesis of OSA and associated diseases.
We designed a case-control study with 146 subjects. Subjects were categorized into four groups by apnea-hypopnea index (AHI) scores: control (n = 32; AHI < 5), mild OSA (n = 32; 5 ≤ AHI < 15), moderate OSA (n = 34; 15 ≤ AHI < 30), and severe OSA (n = 48; AHI ≥ 30) groups. Serum levels of selenium were measured by atomic absorption spectrometer. Vitamin A, C, and E levels were measured by high-performance liquid chromatography and ultraviolet (HPLC-UV) detector.
After adjusting for age, BMI, and gender, serum selenium and vitamin A levels were found to be higher in patients with OSA compared with controls (ANCOVA, p < 0.008, and p = 0.014 respectively), and levels of these markers increased with the severity of the disease. AHI was positively correlated with selenium (r = 0.289; p < 0.001), and vitamin A levels (r = 0.276; p < 0.001).
These results demonstrated that antioxidant response with increased vitamin A, and selenium concentrations, may be important defense mechanisms in patients with OSA patients who do not have other comorbidities. Antioxidant nutrients or supplements may be implemented as a complementary treatment of OSA to support antioxidant defense.
阻塞性睡眠呼吸暂停（OSA）是一种以睡眠期间上呼吸道反复阻塞为特征的疾病，常伴有氧饱和度下降。抗氧化防御机制对于预防OSA相关疾病和降低死亡率很重要。我们旨在测定无任何合并症的OSA患者的硒以及维生素A、C和E水平，并将结果与对照组进行比较，推测这些发现可能有助于理解OSA及其相关疾病发病机制中的抗氧化机制。
我们设计了一项包含146名受试者的病例对照研究。受试者根据呼吸暂停低通气指数（AHI）得分分为四组：对照组（n = 32；AHI < 5）、轻度OSA组（n = 32；5 ≤ AHI < 15）、中度OSA组（n = 34；15 ≤ AHI < 30）和重度OSA组（n = 48；AHI ≥ 30）。血清硒水平通过原子吸收光谱仪测定。维生素A、C和E水平通过高效液相色谱和紫外（HPLC - UV）检测器测定。
在调整年龄、体重指数和性别后，发现OSA患者的血清硒和维生素A水平高于对照组（协方差分析，分别为p < 0.008和p = 0.014），并且这些标志物的水平随疾病严重程度增加。AHI与硒呈正相关（r = 0.289；p < 0.001）以及维生素A水平呈正相关（r = 0.276；p < 0.001）。
这些结果表明，维生素A和硒浓度增加的抗氧化反应可能是无其他合并症的OSA患者重要的防御机制。抗氧化营养素或补充剂可作为OSA的辅助治疗手段，以支持抗氧化防御。
