The association between obstructive sleep apnea and shortened telomere length: a systematic review and meta-analysis

Objective We aimed to give more precise estimate of relationship between telomere length and obstructive sleep apnea (OSA) by systematically reviewing evidence. Method We conducted a systematic electronic search in the databases of the PUBMED, PsycINFO, OVID(medline) and EMBASE and other resources(such as Google Scholar). The methodological quality of the articles were assessed according to the Newcastle Ottawa Scale. Heterogeneity was assessed by using the chi-square test for Cochrane’s Q statistic and I-squared. When heterogeneity was found to be reasonably high between studies, the random-effects model with the mean difference (95% CIs) were conducted with RevMan 5 software by using the inverse variance method(P <0.05; chi-square test). In contrast, the fixed-effects model was carried out. Results Eight eligible studies containing 2,639 participants were included in our meta-analysis. Shortened telomere length was significantly associated with OSA with mean difference of -0.03 (95% CI: -0.06, -0.00; P=0.003 with I-square of 85%). The results of subgroup analysis preformed by age and sample number suggested that shorter telomere length was significantly associated with OSA, with mean difference of -0.07(95% CI: -0.07, -0.01; P=0.005) for adult group and -0.04(95% CI: -0.02, -0.06; P=0.005) for large-sample studies. Conclusion Compared to healthy people, individuals with OSA have shorter telomeres length, which implicates early intervention and timely treatment for preventing future adverse outcomes.