Department of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The University of Arizona, College of Medicine Tucson, 1625 N Campbell Ave, Tucson, AZ, 85719, USA.
Division of Clinical Data Analytics and Decision Support, Department of Internal Medicine, The University of Arizona College of Medicine Phoenix, AZ, USA.
Sleep Med Rev. 2023 Jun;69:101774. doi: 10.1016/j.smrv.2023.101774. Epub 2023 Mar 24.
We conducted this systematic review and meta-analysis to evaluate the impact of obstructive sleep apnea (OSA) on gut barrier dysfunction as represented by the following biomarkers: zonulin, lipopolysaccharide, lipopolysaccharide binding protein, intestinal fatty acid binding protein, and lactic acid. A comprehensive search of the literature was conducted in Ovid MEDLINE, Embase, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov without language restrictions from inception to October 2022. The analysis of all outcomes was performed using a random-effects model. We included eight studies (seven cross sectional and one case control) in the final quantitative synthesis with a total of 897 patients. We concluded that OSA was associated with higher levels of gut barrier dysfunction biomarkers [Hedges' g = 0.73 (95%CI 0.37-1.09, p < 0.01). Biomarker levels were positively correlated with the apnea-hypopnea index [r = 0.48 (95%CI 0.35-0.6, p < 0.01)] and oxygen desaturation index [r = 0.30 (95%CI 0.17-0.42, p < 0.01)], and negatively correlated with the nadir oxygen desaturation values [r = -0.45 (95%CI - 0.55 - - 0.32, p < 0.01). Our systematic review and meta-analysis suggests that OSA is associated with gut barrier dysfunction. Furthermore, OSA severity appears to be correlated with higher biomarkers of gut barrier dysfunction. PROSPERO REGISTRATION NUMBER: CRD42022333078.
我们进行了这项系统评价和荟萃分析，以评估阻塞性睡眠呼吸暂停（OSA）对肠道屏障功能障碍的影响，其代表生物标志物为：紧密连接蛋白、脂多糖、脂多糖结合蛋白、肠脂肪酸结合蛋白和乳酸。从成立之初到 2022 年 10 月，我们在 Ovid MEDLINE、Embase、Scopus、Cochrane 对照试验中心注册库和 ClinicalTrials.gov 中进行了全面的文献检索，没有语言限制。所有结局的分析均采用随机效应模型进行。我们最终的定量综合分析纳入了八项研究（七项横断面研究和一项病例对照研究），共有 897 名患者。我们得出结论，OSA 与更高水平的肠道屏障功能障碍生物标志物相关[Hedges' g = 0.73（95%CI 0.37-1.09，p < 0.01）]。生物标志物水平与呼吸暂停低通气指数呈正相关[r = 0.48（95%CI 0.35-0.6，p < 0.01)]和氧减饱和度指数[r = 0.30（95%CI 0.17-0.42，p < 0.01)]，与最低氧减饱和度值呈负相关[r = -0.45（95%CI -0.55 - - 0.32，p < 0.01)]。我们的系统评价和荟萃分析表明，OSA 与肠道屏障功能障碍有关。此外，OSA 的严重程度似乎与更高的肠道屏障功能障碍生物标志物相关。PROSPERO 注册号：CRD42022333078。
