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(Circulation. 2003;108:1451.)
© 2003 American Heart Association, Inc.

Clinical Investigation and Reports

Serum Amyloid A in Obstructive Sleep Apnea

Anna Svatikova; Robert Wolk, MD, PhD; Abu S. Shamsuzzaman, MBBS, PhD; Tomas Kara, MD; Eric J. Olson, MD; Virend K. Somers, MD, PhD

From the Mayo Foundation, Rochester, Minn.

Correspondence to Virend K. Somers, MD, DPhil, Mayo Clinic, Rochester, MN 55905. E-mail somers.virend{at}mayo.edu

Received January 15, 2003; de novo received May 6, 2003; accepted July 9, 2003.

Background— Patients with severe obstructive sleep apnea (OSA) may have increased risk for cardiovascular and cerebrovascular diseases. Serum amyloid A (SAA) protein has recently been linked to the development of atherosclerosis, stroke, diabetes, and dementia. We tested the hypothesis that plasma SAA levels are increased in otherwise healthy subjects with OSA.

Methods and Results— Plasma SAA levels were measured in 10 male patients with moderate to severe OSA before sleep, after 5 hours of untreated OSA, and in the morning after effective continuous positive airway pressure treatment. SAA levels were also measured in 10 closely matched control subjects at similar time points. Baseline plasma SAA levels before sleep were strikingly higher in patients with moderate to severe OSA than in controls (18.8±2.6 versus 7.2±2.6 µg/mL, respectively; P=0.005) and remained unchanged in both groups throughout the night. SAA levels in 10 male patients with mild OSA were comparable with controls (P=0.46). Plasma SAA in 7 female patients with moderate to severe OSA was also markedly higher compared with matched control female subjects (24.1±2.4 versus 10.2±2.4 µg/mL, respectively; P=0.0013) but was not different from male patients with moderate to severe OSA (P=0.3). There was a significant positive correlation between SAA and apnea-hypopnea index (r=0.40, P=0.03).

Conclusions— Plasma SAA levels are more than 2-fold greater in patients with moderate to severe OSA compared with subjects with mild OSA or healthy controls regardless of gender. Elevated SAA may contribute to any increased risk for cardiovascular and neuronal dysfunction in patients with OSA.

Key Words: amyloid • sleep • cardiovascular diseases

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