School of Nursing, Emory University, 1520 Clifton Road, 243, Atlanta, GA, 30322, USA.
Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
Sleep Breath. 2021 Sep;25(3):1495-1502. doi: 10.1007/s11325-020-02257-0. Epub 2021 Jan 6.
Continuous positive airway pressure (CPAP) therapy reduces circulating intercellular adhesion molecule 1 (ICAM-1) in adults with obstructive sleep apnea (OSA). ICAM-1 levels may affect the daytime sleepiness and elevated blood pressure associated with OSA. We evaluated the association of changes from baseline in ICAM-1 with changes of objective and subjective measures of sleepiness, as well as 24-h ambulatory blood pressure monitoring (ABPM) measures, following 4 months of CPAP treatment.
The study sample included adults with newly diagnosed OSA. Plasma ICAM-1, 24-h ABPM, Epworth Sleepiness Scale (ESS), and psychomotor vigilance task (PVT) were obtained at baseline and following adequate CPAP treatment. The associations between changes in natural log ICAM-1 and changes in the number of lapses on PVT, ESS score, and 24-h mean arterial blood pressure (MAP) were assessed using multivariate regression models, controlling for a priori baseline covariates of age, sex, BMI, race, site, smoking status, physical activity, anti-hypertensive medications, AHI, and daily hours of CPAP use.
Among 140 adults (83% men), mean (± SD) body mass index (BMI) was 31.5 ± 4.2 kg/m, and apnea-hyopnea index (AHI) was 36.8 ± 15.3 events/h. Sleepiness measures, although not ICAM-1 or ABPM measures, improved significantly following CPAP treatment. We observed no statistically significant associations between the change in ICAM-1 and changes in sleepiness, MAP, or other ABPM measures.
Changes in ICAM-1 levels were not related to changes in sleepiness or ABPM following CPAP treatment of adults with OSA. Future work should explore whether or not other biomarkers may have a role in mediating these treatment outcomes in adults with OSA.
持续气道正压通气（CPAP）治疗可降低阻塞性睡眠呼吸暂停（OSA）患者的循环细胞间黏附分子 1（ICAM-1）水平。ICAM-1 水平可能会影响 OSA 相关的日间嗜睡和血压升高。我们评估了 CPAP 治疗 4 个月后，ICAM-1 从基线的变化与客观和主观嗜睡指标以及 24 小时动态血压监测（ABPM）测量值的变化之间的关联。
研究对象为新诊断为 OSA 的成年人。在基线和接受足够 CPAP 治疗后，测量了血浆 ICAM-1、24 小时 ABPM、Epworth 嗜睡量表（ESS）和精神运动警觉任务（PVT）。使用多元回归模型评估自然对数 ICAM-1 的变化与 PVT 漏数、ESS 评分和 24 小时平均动脉血压（MAP）变化之间的关系，模型中控制了年龄、性别、BMI、种族、地点、吸烟状况、身体活动、抗高血压药物、AHI 和 CPAP 使用每日时间等基线协变量。
在 140 名成年人（83%为男性）中，平均（±SD）体重指数（BMI）为 31.5±4.2kg/m，呼吸暂停低通气指数（AHI）为 36.8±15.3 次/小时。尽管嗜睡测量值没有改善，但 CPAP 治疗后，ICAM-1 和 ABPM 测量值显著改善。我们没有观察到 ICAM-1 变化与嗜睡变化、MAP 或其他 ABPM 测量值之间存在统计学显著关联。
在 OSA 成人接受 CPAP 治疗后，ICAM-1 水平的变化与嗜睡或 ABPM 变化无关。未来的研究应该探讨其他生物标志物是否在介导 OSA 成人的这些治疗结果方面发挥作用。
