阻塞性睡眠呼吸暂停、慢性阻塞性肺疾病和慢性阻塞性肺疾病/阻塞性睡眠呼吸暂停重叠综合征中的炎症生物标志物。

Inflammation biomarkers in OSA, chronic obstructive pulmonary disease, and chronic obstructive pulmonary disease/OSA overlap syndrome.

机构信息

Division of Pulmonary, Critical Care, and Sleep Medicine and Physiology, Department of Medicine, University of California, La Jolla, California.

Division of Pulmonary and Sleep Medicine. Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, España.

出版信息

J Clin Sleep Med. 2023 Aug 1;19(8):1447-1456. doi: 10.5664/jcsm.10600.

DOI:10.5664/jcsm.10600

PMID:37082823

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10394367/

Abstract

STUDY OBJECTIVES

The coexistence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) in a single individual, also known as overlap syndrome (OVS), is associated with higher cardiovascular risk and mortality than either OSA or COPD alone. However, the underlying mechanisms remain unclear. We hypothesized that patients with OVS have elevated systemic inflammatory biomarkers relative to patients with either disease alone, which could explain greater cardiovascular risk observed in OVS.

METHODS

We included 255 participants in the study, 55 with COPD alone, 100 with OSA alone, 50 with OVS, and 50 healthy controls. All participants underwent a home sleep study, spirometry, and a blood draw for high-sensitivity C-reactive protein and total blood count analysis. In a randomly selected subset of 186 participants, inflammatory protein profiling was performed using Bio-Rad Bio-Plex Pro Human Cytokine 27-Plex Assays. Biomarker level differences across groups were identified using a mixed linear model.

RESULTS

Levels of interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and granulocyte colony stimulating factor (G-CSF) were higher in participants with OVS and COPD compared with healthy controls and participants with OSA. Furthermore, participants with OVS had higher circulating levels of leukocytes and neutrophils than those with COPD, OSA, and controls.

CONCLUSIONS

COPD and OVS are associated with higher systemic inflammation relative to OSA and healthy controls. This work proposes the potential utilization of interleukin 6, granulocyte colony stimulating factor, and high-sensitivity C-reactive protein as screening biomarkers for COPD in patients with OSA. Inflammatory pathways may not fully explain the higher cardiovascular risk observed in OVS, indicating the need for further investigation.

CITATION

Sanchez-Azofra A, Gu W, Masso-Silva JA, et al. Inflammation biomarkers in OSA, chronic obstructive pulmonary disease, and chronic obstructive pulmonary disease/OSA overlap syndrome. . 2023;19(8):1447-1456.

摘要

研究目的

阻塞性睡眠呼吸暂停（OSA）和慢性阻塞性肺疾病（COPD）在单个个体中同时存在，也称为重叠综合征（OVS），与单纯 OSA 或 COPD 相比，心血管风险和死亡率更高。然而，其潜在机制仍不清楚。我们假设 OVS 患者的全身炎症生物标志物水平高于单纯患有 OSA 或 COPD 的患者，这可以解释在 OVS 中观察到的更大心血管风险。

方法

我们纳入了 255 名参与者的研究，其中 55 名患有 COPD，100 名患有 OSA，50 名患有 OVS，50 名健康对照者。所有参与者均接受家庭睡眠研究、肺量测定法以及高敏 C 反应蛋白和全血细胞计数分析的血液采集。在 186 名随机选择的参与者中，使用 Bio-Rad Bio-Plex Pro Human Cytokine 27-Plex Assays 进行炎症蛋白谱分析。使用混合线性模型确定各组之间生物标志物水平的差异。