Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Sleep Breath. 2023 Jun;27(3):1033-1042. doi: 10.1007/s11325-022-02697-w. Epub 2022 Aug 19.
Obstructive sleep apnea (OSA) shows a chronic inflammatory state which is often accompanied by cardiometabolic phenotypes. The aim of this study was to investigate whether or not there were differences of inflammatory proteins levels in patients with OSA with and without a certain phenotype so as to explore the associations between inflammation and additional OSA phenotypes.
The literature was systematically screened and available data were collected on levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and several interleukins (ILs) in patients with OSA with and without a certain phenotype. Overall effect size of standard mean difference (SMD) was used to compare the expression of differences between the two groups. Data analysis was conducted by Review Manager 5.3, and the threshold of p value was set as < 0.05.
A total of 31 articles were included, covering five traits of obesity, hypertension (HBP), metabolic syndrome (MS), heart disease, and sex. There were elevated levels of TNF-α (SMD = 0.63, p = 0.03), CRP (SMD = 0.64, p = 0.0001), and IL-6 (SMD = 0.83, p = 0.008) levels in OSA with obesity. Also, OSA with HBP showed significant increases of TNF-α (SMD = 0.36, p = 0.02), CRP (SMD = 0.98, p = 0.01), and IL-6 (SMD = 0.76, p < 0.0001) levels. A higher CRP level was also observed in OSA with MS (SMD = 0.31, p = 0.004) and female sex (SMD = 0.21, p = 0.002). There were no statistical differences for IL-1β (p = 0.22) and CRP (p = 0.14) levels of OSA with obesity and heart disease respectively compared with OSA without corresponding phenotype. TNF-α (p = 0.66) and IL-6 (p = 0.49) levels also lacked statistically significant differences between female and male patients with OSA.
Our results revealed that inflammatory proteins TNF-α, CRP, and IL-6 levels were higher in obese and hypertensive patients with OSA and CRP levels were higher in OSA with metabolic syndrome, highlighting a link between inflammation and cardiometabolic complications in patients with OSA.
阻塞性睡眠呼吸暂停（OSA）表现为慢性炎症状态，常伴有心脏代谢表型。本研究旨在探讨 OSA 患者是否存在不同表型的炎症蛋白水平差异，以探索炎症与 OSA 附加表型之间的关系。
系统筛选文献，收集 OSA 患者伴或不伴特定表型的肿瘤坏死因子-α（TNF-α）、C 反应蛋白（CRP）和几种白细胞介素（ILs）水平的可用数据。采用标准化均数差（SMD）的总效应大小来比较两组之间的表达差异。采用 Review Manager 5.3 进行数据分析，p 值阈值设为<0.05。
共纳入 31 篇文章，涵盖肥胖、高血压（HBP）、代谢综合征（MS）、心脏病和性别 5 个特征。肥胖的 OSA 患者 TNF-α（SMD=0.63，p=0.03）、CRP（SMD=0.64，p=0.0001）和 IL-6（SMD=0.83，p=0.008）水平升高。伴有 HBP 的 OSA 患者 TNF-α（SMD=0.36，p=0.02）、CRP（SMD=0.98，p=0.01）和 IL-6（SMD=0.76，p<0.0001）水平显著升高。伴有 MS 的 OSA 患者 CRP 水平也较高（SMD=0.31，p=0.004），女性 OSA 患者 CRP 水平较高（SMD=0.21，p=0.002）。与不伴有相应表型的 OSA 相比，肥胖和心脏病的 OSA 患者的 IL-1β（p=0.22）和 CRP（p=0.14）水平无统计学差异。TNF-α（p=0.66）和 IL-6（p=0.49）水平在 OSA 男性和女性患者之间也无统计学差异。
我们的结果表明，肥胖和高血压的 OSA 患者的炎症蛋白 TNF-α、CRP 和 IL-6 水平较高，伴有代谢综合征的 OSA 患者的 CRP 水平较高，提示 OSA 患者的炎症与心脏代谢并发症之间存在关联。
