Pintilie Adriana-Loredana, Zabara Antal Andreea, Ciuntu Bogdan-Mihnea, Toma David, Tiron Raluca, Stirbu Ruxandra, Zabara Mihai Lucian, Crisan Dabija Radu
Clinical Hospital of Pulmonary Diseases Iași, 700116 Iasi, Romania.
Faculty of General Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania.
Healthcare (Basel). 2025 May 19;13(10):1177. doi: 10.3390/healthcare13101177.
Obstructive sleep apnea (OSA) is increasingly recognized as a chronic condition associated with systemic low-grade inflammation. Elevated levels of inflammatory markers such as C-reactive protein (CRP), fibrinogen, TNF-α, and IL-6 have been observed in OSA patients, independent of obesity. Tobacco use, a known pro-inflammatory factor, may further exacerbate this burden. This study aimed to evaluate whether smoking influences inflammatory markers and OSA severity in newly diagnosed patients. We conducted a retrospective, observational study on individuals newly diagnosed with OSA between 1 January 2024 and 31 December 2024 at the Clinical Hospital of Pulmonary Diseases Iași. All participants underwent overnight respiratory polygraphy using the SleepDoc Porti 9 system (Löwenstein Medical), with OSA severity classified according to the American Academy of Sleep Medicine (AASM) criteria. Inflammatory status was assessed using CRP and the erythrocyte sedimentation rate (ESR). Smokers were defined as individuals who had smoked within the past year; non-smokers had a lifetime history of fewer than 50 cigarettes. Statistical analysis was performed using IBM SPSS Statistics. Smokers (n = 55) shoation Index (ODI) values, compared to non-smokers (n = 49): AHI 45.29 ± 20.94 vs. 38.40 ± 19.84 events/hour, ODI 45.69 ± 21.05 vs. 38.44 ± 19.40 events/hour ( < 0.05 for both). Mean CRP levels were approximately 3.5 times higher in smokers (10.32 ± 11.69 mg/dL) than in non-smokers (2.97 ± 2.45 mg/dL), indicating a significantly elevated inflammatory burden. The inflammatory burden and clinical severity of OSA may be influenced by smoking. Routine inflammatory marker screening, particularly CRP, may improve risk stratification and treatment planning in OSA patients, especially those who smoke or are obese. Routine assessment of CRP and other inflammatory markers may improve risk stratification and guide personalized treatment strategies, particularly in smokers and obese patients with OSA.
阻塞性睡眠呼吸暂停（OSA）越来越被认为是一种与全身低度炎症相关的慢性疾病。在OSA患者中，已观察到炎症标志物如C反应蛋白（CRP）、纤维蛋白原、肿瘤坏死因子-α和白细胞介素-6水平升高，且与肥胖无关。吸烟作为一种已知的促炎因素，可能会进一步加重这种负担。本研究旨在评估吸烟是否会影响新诊断患者的炎症标志物和OSA严重程度。我们对2024年1月1日至2024年12月31日期间在雅西肺病临床医院新诊断为OSA的个体进行了一项回顾性观察研究。所有参与者均使用SleepDoc Porti 9系统（洛温斯坦医疗公司）进行夜间呼吸多导睡眠监测，OSA严重程度根据美国睡眠医学学会（AASM）标准进行分类。使用CRP和红细胞沉降率（ESR）评估炎症状态。吸烟者定义为过去一年内吸烟的个体；非吸烟者一生吸烟少于50支。使用IBM SPSS Statistics进行统计分析。吸烟者（n = 55）的呼吸暂停低通气指数（AHI）和血氧不足指数（ODI）值高于非吸烟者（n = 49）：AHI为45.29±20.94次/小时，而后者为38.40±19.84次/小时；ODI为45.69±21.05次/小时，而后者为38.44±19.40次/小时（两者均P<0.05）。吸烟者的平均CRP水平（10.32±11.69mg/dL）约为非吸烟者（2.97±2.45mg/dL）的3.5倍，表明炎症负担显著升高。吸烟可能会影响OSA的炎症负担和临床严重程度。常规炎症标志物筛查，尤其是CRP，可能会改善OSA患者的风险分层和治疗计划，特别是那些吸烟或肥胖的患者。对CRP和其他炎症标志物的常规评估可能会改善风险分层并指导个性化治疗策略，特别是在吸烟和肥胖的OSA患者中。
