Circulation. 2003;107:1129-1134
Published online before print February 24, 2003, doi: 10.1161/01.CIR.0000052627.99976.18
Published online before print February 24, 2003, doi: 10.1161/01.CIR.0000052627.99976.18
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2003;107:1129.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
Elevated Levels of C-Reactive Protein and Interleukin-6 in Patients With Obstructive Sleep Apnea Syndrome Are Decreased by Nasal Continuous Positive Airway Pressure
From the First Department of Internal Medicine (T.Y., K.M., H. Matsuo, N.O., H. Minoguchi, T.H., M.A.), Showa University, and the Department of Laboratory Medicine (G.Y.), Toho University, Tokyo, Japan.
Correspondence to Kenji Minoguchi, MD, PhD, First Department of Internal Medicine, Showa University, School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan. E-mail minochan{at}fn.catv.ne.jp
Background— C-reactive protein (CRP) and interleukin (IL)-6 are important risk factors for atherosclerosis and coronary heart disease. In the present study, we examined serum levels of CRP and IL-6, IL-6 production by monocytes, and the effect of nasal continuous positive airway pressure (nCPAP) in patients with obstructive sleep apnea syndrome (OSAS).
Methods and Results— After polysomnography, venous blood was collected at 5 AM from 30 patients with OSAS and 14 obese control subjects. Serum levels of CRP and IL-6 and spontaneous production of IL-6 by monocytes were investigated. In addition, the effects of 1 month of nCPAP were studied in patients with moderate to severe OSAS. Levels of CRP and IL-6 were significantly higher in patients with OSAS than in obese control subjects (CRP P<0.001, IL-6 P<0.05). IL-6 production by monocytes was also higher in patients with OSAS than in obese control subjects (P<0.01). In patients with OSAS, the primary factors influencing levels of CRP were severity of OSAS and body mass index and those influencing levels of IL-6 were body mass index and nocturnal hypoxia. nCPAP significantly decreased levels of both CRP (P<0.0001) and IL-6 (P<0.001) and spontaneous IL-6 production by monocytes (P<0.01).
Conclusions— Levels of CRP and IL-6 and spontaneous production of IL-6 by monocytes are elevated in patients with OSAS but are decreased by nCPAP. Therefore, OSAS is associated with increased risks for cardiovascular morbidity and mortality, and nCPAP may be useful for decreasing these risks.
Key Words: sleep • hypoxia • inflammation • atherosclerosis • cardiovascular diseases
This article has been cited by other articles:
 |
|
 |
|
  N. Burioka, S. Koyanagi, M. Endo, M. Takata, Y. Fukuoka, M. Miyata, K. Takeda, H. Chikumi, S. Ohdo, and E. Shimizu Clock gene dysfunction in patients with obstructive sleep apnoea syndrome Eur. Respir. J., July 1, 2008; 32(1): 105 - 112. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Hayashi, C. Yamashita, C. Matsumoto, C.-J. Kwak, K. Fujii, T. Hirata, M. Miyamura, T. Mori, A. Ukimura, Y. Okada, et al. Role of gp91phox-containing NADPH oxidase in left ventricular remodeling induced by intermittent hypoxic stress Am J Physiol Heart Circ Physiol, May 1, 2008; 294(5): H2197 - H2203. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. M. Nater, L. S. Youngblood, J. F. Jones, E. R. Unger, A. H. Miller, W. C. Reeves, and C. Heim Alterations in Diurnal Salivary Cortisol Rhythm in a Population-Based Sample of Cases With Chronic Fatigue Syndrome Psychosom Med, April 1, 2008; 70(3): 298 - 305. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Lopez-Jimenez, F. H. Sert Kuniyoshi, A. Gami, and V. K. Somers Obstructive Sleep Apnea: Implications for Cardiac and Vascular Disease Chest, March 1, 2008; 133(3): 793 - 804. [Full Text] [PDF]
|
|
|
|
 |
|
 M. H. Sanders, J. M. Montserrat, R. Farre, and R. J. Givelber Positive Pressure Therapy: A Perspective on Evidence-based Outcomes and Methods of Application Proceedings of the ATS, February 15, 2008; 5(2): 161 - 172. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Tasali and M. S. M. Ip Obstructive Sleep Apnea and Metabolic Syndrome: Alterations in Glucose Metabolism and Inflammation Proceedings of the ATS, February 15, 2008; 5(2): 207 - 217. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Yokoe, L. C. Alonso, L. C. Romano, T. C. Rosa, Robert. M. O'Doherty, A. Garcia-Ocana, K. Minoguchi, and C. P. O'Donnell Intermittent hypoxia reverses the diurnal glucose rhythm and causes pancreatic {beta}-cell replication in mice J. Physiol., February 1, 2008; 586(3): 899 - 911. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. J. Buchner, B. M. Sanner, J. Borgel, and L. C. Rump Continuous Positive Airway Pressure Treatment of Mild to Moderate Obstructive Sleep Apnea Reduces Cardiovascular Risk Am. J. Respir. Crit. Care Med., December 15, 2007; 176(12): 1274 - 1280. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. A. Harsch Metabolic disturbances in patients with obstructive sleep apnoea syndrome Eur. Respir. Rev., December 1, 2007; 16(106): 196 - 202. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Cassar, T. I. Morgenthaler, R. J. Lennon, C. S. Rihal, and A. Lerman Treatment of Obstructive Sleep Apnea Is Associated With Decreased Cardiac Death After Percutaneous Coronary Intervention J. Am. Coll. Cardiol., October 2, 2007; 50(14): 1310 - 1314. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. F. Drager, L. A. Bortolotto, A. C. Figueiredo, E. M. Krieger, and G. Lorenzi-Filho Effects of Continuous Positive Airway Pressure on Early Signs of Atherosclerosis in Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., October 1, 2007; 176(7): 706 - 712. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. M. Punjabi, B. A. Beamer, A. Jain, M. E. Spencer, and N. Fedarko Elevated Levels of Neopterin in Sleep-Disordered Breathing Chest, October 1, 2007; 132(4): 1124 - 1130. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. T. McNicholas Cardiovascular outcomes of CPAP therapy in obstructive sleep apnea syndrome Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2007; 293(4): R1666 - R1670. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Parati, C. Lombardi, and K. Narkiewicz Sleep apnea: epidemiology, pathophysiology, and relation to cardiovascular risk Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2007; 293(4): R1671 - R1683. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Ye, Z. Gao, J. Yin, and Q. He Hypoxia is a potential risk factor for chronic inflammation and adiponectin reduction in adipose tissue of ob/ob and dietary obese mice Am J Physiol Endocrinol Metab, October 1, 2007; 293(4): E1118 - E1128. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. K. Kakkar and R. B. Berry Positive Airway Pressure Treatment for Obstructive Sleep Apnea Chest, September 1, 2007; 132(3): 1057 - 1072. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Steiropoulos, V. Tsara, E. Nena, C. Fitili, M. Kataropoulou, M. Froudarakis, P. Christaki, and D. Bouros Effect of Continuous Positive Airway Pressure Treatment on Serum Cardiovascular Risk Factors in Patients With Obstructive Sleep Apnea-Hypopnea Syndrome Chest, September 1, 2007; 132(3): 843 - 851. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Foresi, C. Leone, D. Olivieri, and G. Cremona Alveolar-Derived Exhaled Nitric Oxide Is Reduced in Obstructive Sleep Apnea Syndrome Chest, September 1, 2007; 132(3): 860 - 867. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Ryan, G. M Nolan, E. Hannigan, S. Cunningham, C. Taylor, and W. T McNicholas Cardiovascular risk markers in obstructive sleep apnoea syndrome and correlation with obesity Thorax, June 1, 2007; 62(6): 509 - 514. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A. El Solh, M. E. Akinnusi, F. H. Baddoura, and C. R. Mankowski Endothelial Cell Apoptosis in Obstructive Sleep Apnea: A Link to Endothelial Dysfunction Am. J. Respir. Crit. Care Med., June 1, 2007; 175(11): 1186 - 1191. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Patruno, S. Aiolfi, G. Costantino, R. Murgia, C. Selmi, A. Malliani, and N. Montano Fixed and Autoadjusting Continuous Positive Airway Pressure Treatments Are Not Similar in Reducing Cardiovascular Risk Factors in Patients With Obstructive Sleep Apnea Chest, May 1, 2007; 131(5): 1393 - 1399. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. J. Williams, F. B. Hu, S. R. Patel, and C. S. Mantzoros Sleep Duration and Snoring in Relation to Biomarkers of Cardiovascular Disease Risk Among Women With Type 2 Diabetes Diabetes Care, May 1, 2007; 30(5): 1233 - 1240. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Cereda and A. E. Malavazos A Possible Role of Visceral Fat-Related Inflammation in Linking Obstructive Sleep Apnea to Left Ventricular Hypertrophy Hypertension, April 1, 2007; 49(4): e23 - e23. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Wolk and V. K. Somers Sleep Apnoea & Hypertension: Physiological bases for a causal relation: Sleep and the metabolic syndrome Exp Physiol, January 1, 2007; 92(1): 67 - 78. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ryan, CormacT. Taylor, and WalterT. McNicholas Predictors of elevated tumour necrosis factor {alpha} level in obstructive sleep apnoea syndrome Eur. Respir. Rev., December 1, 2006; 15(101): 221 - 223. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. G. Kaditis, E. I. Alexopoulos, F. Hatzi, E. Kostadima, M. Kiaffas, E. Zakynthinos, and K. Gourgoulianis Overnight change in brain natriuretic Peptide levels in children with sleep-disordered breathing. Chest, November 1, 2006; 130(5): 1377 - 1384. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ryan, C. T. Taylor, and W. T. McNicholas Predictors of Elevated Nuclear Factor-{kappa}B-dependent Genes in Obstructive Sleep Apnea Syndrome Am. J. Respir. Crit. Care Med., October 1, 2006; 174(7): 824 - 830. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Mehra, A. Storfer-Isser, H. L. Kirchner, N. Johnson, N. Jenny, R. P. Tracy, and S. Redline Soluble interleukin 6 receptor: a novel marker of moderate to severe sleep-related breathing disorder. Arch Intern Med, September 18, 2006; 166(16): 1725 - 1731. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Minoguchi, T. Yokoe, A. Tanaka, S. Ohta, T. Hirano, G. Yoshino, C. P. O'Donnell, and M. Adachi Association between lipid peroxidation and inflammation in obstructive sleep apnoea. Eur. Respir. J., August 1, 2006; 28(2): 378 - 385. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N T Ayas, G B J Mancini, and J Fleetham Does CPAP delay the development of cardiovascular disease in patients with obstructive sleep apnoea hypopnoea? Thorax, June 1, 2006; 61(6): 459 - 460. [Full Text] [PDF]
|
|
|
|
|
|
N. T. Ayas, J. M. FitzGerald, J. A. Fleetham, D. P. White, M. Schulzer, C. F. Ryan, R. Ghaeli, G. W. Mercer, P. Cooper, M. C. Y. Tan, et al. Cost-effectiveness of Continuous Positive Airway Pressure Therapy for Moderate to Severe Obstructive Sleep Apnea/Hypopnea. Arch Intern Med, May 8, 2006; 166(9): 977 - 984. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kobayashi, Y. Nishimura, T. Shimada, S. Yoshimura, Y. Funada, M. Satouchi, and M. Yokoyama Effect of Continuous Positive Airway Pressure on Soluble CD40 Ligand in Patients With Obstructive Sleep Apnea Syndrome Chest, March 1, 2006; 129(3): 632 - 637. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Olson and V. K. Somers Modulation of cardiovascular risk factors by obstructive sleep apnea. Chest, February 1, 2006; 129(2): 218 - 220. [Full Text] [PDF]
|
|
|
|
|
|
M. Can, S. Acikgoz, G. Mungan, T. Bayraktaroglu, E. Kocak, B. Guven, and S. Demirtas Serum cardiovascular risk factors in obstructive sleep apnea. Chest, February 1, 2006; 129(2): 233 - 237. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Alonso-Fernandez, F. Garcia-Rio, M. A. Arias, O. Mediano, J. M. Pino, I. Martinez, and J. Villamor Obstructive sleep apnoea-hypoapnoea syndrome reversibly depresses cardiac response to exercise Eur. Heart J., January 2, 2006; 27(2): 207 - 215. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. I. Pack Advances in Sleep-disordered Breathing Am. J. Respir. Crit. Care Med., January 1, 2006; 173(1): 7 - 15. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. K. Yaggi, J. Concato, W. N. Kernan, J. H. Lichtman, L. M. Brass, and V. Mohsenin Obstructive Sleep Apnea as a Risk Factor for Stroke and Death. N. Engl. J. Med., November 10, 2005; 353(19): 2034 - 2041. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-P. Baguet, L. Hammer, P. Levy, H. Pierre, S. Launois, J.-M. Mallion, and J.-L. Pepin The Severity of Oxygen Desaturation Is Predictive of Carotid Wall Thickening and Plaque Occurrence Chest, November 1, 2005; 128(5): 3407 - 3412. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Ryan, C. T. Taylor, and W. T. McNicholas Selective Activation of Inflammatory Pathways by Intermittent Hypoxia in Obstructive Sleep Apnea Syndrome Circulation, October 25, 2005; 112(17): 2660 - 2667. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. F. Drager, L. A. Bortolotto, M. C. Lorenzi, A. C. Figueiredo, E. M. Krieger, and G. Lorenzi-Filho Early Signs of Atherosclerosis in Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., September 1, 2005; 172(5): 613 - 618. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. K. Larkin, C. L. Rosen, H. L. Kirchner, A. Storfer-Isser, J. L. Emancipator, N. L. Johnson, A. M. V. Zambito, R. P. Tracy, N. S. Jenny, and S. Redline Variation of C-Reactive Protein Levels in Adolescents: Association With Sleep-Disordered Breathing and Sleep Duration Circulation, April 19, 2005; 111(15): 1978 - 1984. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Dhindsa, S. Prabhakar, and P. Dandona Authors' Response: Frequent Occurrence of Hypogonadotropic Hypogonadism in Type 2 Diabetes J. Clin. Endocrinol. Metab., March 1, 2005; 90(3): 1903 - 1903. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Guo, S. Takahashi, S. Cho, T. Hara, S. Tomiyasu, and K. Sumikawa The Effects of Dexmedetomidine on Left Ventricular Function During Hypoxia and Reoxygenation in Isolated Rat Hearts Anesth. Analg., March 1, 2005; 100(3): 629 - 635. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Kelly and C. L. Marcus Childhood Obesity, Inflammation, and Apnea: What Is the Future for Our Children? Am. J. Respir. Crit. Care Med., February 1, 2005; 171(3): 202 - 203. [Full Text] [PDF]
|
|
|
|
|
|
A. G. Kaditis, E. I. Alexopoulos, E. Kalampouka, E. Kostadima, A. Germenis, E. Zintzaras, and K. Gourgoulianis Morning Levels of C-Reactive Protein in Children with Obstructive Sleep-disordered Breathing Am. J. Respir. Crit. Care Med., February 1, 2005; 171(3): 282 - 286. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Tazaki, K. Minoguchi, T. Yokoe, K. T. R. Samson, H. Minoguchi, A. Tanaka, Y. Watanabe, and M. Adachi Increased Levels and Activity of Matrix Metalloproteinase-9 in Obstructive Sleep Apnea Syndrome Am. J. Respir. Crit. Care Med., December 15, 2004; 170(12): 1354 - 1359. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Vassilakopoulos, C. Roussos, and S. Zakynthinos The immune response to resistive breathing Eur. Respir. J., December 1, 2004; 24(6): 1033 - 1043. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.G. Kaditis, E.I. Alexopoulos, E. Kalampouka, E. Kostadima, N. Angelopoulos, A. Germenis, E. Zintzaras, and K. Gourgoulianis Morning levels of fibrinogen in children with sleep-disordered breathing Eur. Respir. J., November 1, 2004; 24(5): 790 - 797. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. K. Meier-Ewert, P. M. Ridker, N. Rifai, M. M. Regan, N. J. Price, D. F. Dinges, and J. M. Mullington Reply J. Am. Coll. Cardiol., October 6, 2004; 44(7): 1530 - 1531. [Full Text] [PDF]
|
|
|
|
|
|
A. Svatikova, R. Wolk, H. H. Wang, M. E. Otto, K. A. Bybee, R. J. Singh, and V. K. Somers Circulating free nitrotyrosine in obstructive sleep apnea Am J Physiol Regulatory Integrative Comp Physiol, August 1, 2004; 287(2): R284 - R287. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Hatipoglu and I. Rubinstein Inflammation and Obstructive Sleep Apnea Syndrome: How Many Ways Do I Look at Thee? Chest, July 1, 2004; 126(1): 1 - 2. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Tauman, A. Ivanenko, L. M. O'Brien, and D. Gozal Plasma C-Reactive Protein Levels Among Children With Sleep-Disordered Breathing Pediatrics, June 1, 2004; 113(6): e564 - e569. [Abstract] [Full Text]
|
|
|
|
|
|
O. Milleron, R. Pilliere, A. Foucher, F. de Roquefeuil, P. Aegerter, G. Jondeau, B. G Raffestin, and O. Dubourg Benefits of obstructive sleep apnoea treatment in coronary artery disease: a long-term follow-up study Eur. Heart J., May 1, 2004; 25(9): 728 - 734. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Teramoto, H. Yamamoto, Y. Ouchi, K.-i. Inoue, H. Takano, and T. Yoshika Increased Plasma Interleukin-6 Is Associated With the Pathogenesis of Obstructive Sleep Apnea Syndrome Chest, May 1, 2004; 125(5): 1964 - 1965. [Full Text] [PDF]
|
|