Changes in inflammatory mediators as a result of intermittent hypoxia in obstructive sleep apnea syndrome

Background:Inflammation plays an important role in obstructive sleep apnea syndrome (OSAS). The objective of this study was to investigate the relationship of serum C-reactive protein(CRP), pentraxin-3(PTX-3), procalcitonin(ProCT), interleukin-33(IL-33) and its soluble receptor ST2 (sST2) with the syndrome severity and to show theirs importance as biomarkers. Methods:This study comprises a total of 84 identical (sex and age wise) cases. Full-night polysomnography was performed in each patient. OSAS diagnosis and severity index being based on the widely used criterion known as Apnea Hypopnea Index(AHI). Subgroups were as follows: 24(AHI 30). Results:PTX-3, IL-33 and sST2 receptors were significantly higher in OSAS groups than the control group (p<0.001). However, both CRP and ProCT levels were similar in all subjects. There was a positive correlation between PTX-3 and BMI (r=0.446; p<0.01), ODI(r=0.555; p<0.01), IL-33(r=0.348; p=0.001) and sST2(r=326;p=0.002), while there was a negative correlation with minimum SaO2 (r=-0.672; p<0.01) in patient group. PTX-3 as a predictor of OSAS showed highest specificity (%91.7) and sensitivity (%91.7) (p<0.001). Conclusions: PTX-3 can be a new indicator reflecting the inflammatory state in patients with OSAS. Since patients with OSAS could have more hypoxic state during sleep, we found higher PTX-3 level in those patients and a negtive corralation between PTX-3 and minimum SaO2, which could explain that PTX-3 levels can increase with the severity of disease. Our results suggest that PTX-3 as an inflammatory biomarker may play a crucial role as an indicator of syndrome severity in OSAS. This article is protected by copyright. All rights reserved.