Journal of Sleep Medicine & Disorders
Cite this article: Bulcun E, Dag E, Tulmac M,Cimen DA, Ekici A, et al. (2015) Metabolic Changes and Infammation in Obstructive Sleep Apnea. J Sleep Med
Disord 2(3): 1023.
Central
*Corresponding author
Eme l Bulc un, De p a rtme nt o f Pulmo na ry Me d ic ine ,
University of Kirikkale, 71100/ Kırıkkale, Turkey, Tel: 90-318-
3335-000; Email: emelbulcun@hotmail.com
Submitte d: 20 April 2015
Accepted: 11 May 2015
Publishe d: 13 May 2015
Copyright
© 2015 Bulcun et al.
OPEN ACCESS
Ke ywo rds
• Metabolic syndrome
• Infammation
• Obstructive sleep apnea
Research Article
Metabolic Changes and
Infammation in Obstructive
Sleep Apnea
Emel Bulcun
1
*, Ersel Dag
2
, Murat Tulmac
3
, Dilay Ahad Cimen
1
,
Aydanur Ekici
1
and Mehmet Ekici
1
1
Department of Pulmonary Diseases, University of Kirikkale, University of Kirikkale
2
Department of Neurology, University of Kirikkale, Turkey
3
Department of Cardiology, University of Kirikkale, Turkey
Abstract
Objective: There are different results on low grade infammation and metabolic
syndrome in patients with obstructive sleep apnea (OSA). We investigated the relation
between low grade infammation and metabolic syndrome in patients with OSA.
Methods: This study included 78 OSA patients(AHI ≥5) and 28 control group
(AHI <5). Clinical information, body mass index (BMI), Epworth Sleepiness Scale were
collected. Nocturnal polysomnography was performed and glucose, insulin, high-
density lipoprotein (HDL), low-density lipoprotein (LDL), cholesterol, triglycerides,
CRP were examined in fasting blood samplings. Metabolic syndrome was described
according to National Cholesterol Education Program (NAEP) criteria. Metabolic score
was calculated by adding the number of discrete components of metabolic syndrome.
Results: The components number (2.1±0.9 vs 1.2±0.8, p=0.0001, respectively)
and percentage (33.3% vs 7.1%,p=0.009, respectively) of the metabolic syndrome
and CRP levels (4.3±4.1 vs 2.6±2.9,p=0.01,respectively) were signifcantly higher
in the patients with OSA than control group. In bivariate analyses, the component
number of metabolic syndrome was correlated with the CRP, AHI desaturation index
and minimal O
2
. The component number of metabolic syndrome increased with an
increase in AHI and desaturation index in multivariate analysis independently BMI.
Conclusion: OSA is associated with metabolic syndrome and low grade
infammation. The severity of the metabolic syndrome increased with an increase in
OSA severity. Therapeutic approaches to sleep apnea may decrease cardiovascular
risk by decreasing frequency of metabolic syndrome in patients with OSA.
INTRODUCTION
Obstructive sleep apnea (OSA) is a widely prevalent disorder,
hall marked by partial or total upper airway obstruction during
sleep. These events fracture sleep integrity resulting in chronic
partial sleep deprivation with destructive metabolic sequelae
[1]. The metabolic syndrome is a problem which threatens public
health. Abdominal obesity, increased blood glucose, hypertension,
increased triglycerides, decreased HDL cholesterol are composed
metabolic syndrome. OSA may also be part of the metabolic
syndrome [2]. It has been suggested that the presence of OSA
may increase the risk of developing some of metabolic disorders
such as hypertension, type 2 diabetes, insulin resistance [3,4].
However, there is little evidence available about the relationship
between metabolic syndrome as a comprehensive clinical entity
and OSA with respect to the cardiovascular risk of patients with
coexisting metabolic syndrome and OSA [5].
OSA is a highly prevalent disease and is recognised as a
public health burden and it has significant health consequences.
Inflammatory processes have emerged as critical in the
pathogenesis of atherosclerosis at all stages of atheroma formation
[6,7]. The relation between increased systemic inflammatory
responses and OSA has been found and this inflammation
response increases risk for end-organ morbidity [8]. It is widely
accepted that OSA is linked with cardiovascular diseases. The
relationship is complex and remains still poorly understood. The
presence of chronic systemic inflammation has been connected
with pathogenesis of both OSA and cardiovascular diseases [9].
C-reactive protein (CRP), a marker of systemic inflammation,
is an important predictor of future cardiovascular events [10].
Systemic low grade inflammation may adversely effect health
status outcomes. Low grade inflammation is a findings chronic
diseases [11]. The intermittent hypoxaemia causes to increase
of cardiovascular morbidity with inflammatory processes [12].