Vitamin D deficiency and interleukin-17 relationship in severe obstructive sleep apnea-hypopnea syndrome

Abstract

Purpose: We aimed to assess Vitamin D (VD) abnormalities in patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS), to study its association with clinical and polygraphic data, and to correlate VD levels with interleukin-17 (IL-17).

Methods: Ninety-two patients with severe OSAHS were consecutively enrolled between September 2014 and February 2016 and compared to age-, sex-, and body mass index (BMI)-matched controls. Anthropometric parameters and medical history were collected. The serum levels of VD and IL-17 were determined by radioimmunoassay and enzyme-linked immunosorbent assay, respectively.

Results: Ninety-two severe OSAHS patients and thirty controls were enrolled in the study. All OSAHS patients had VD deficiency. The mean level of VD was at 7.9 ng/ml among OSAHS group versus 16.8 ng/ml among control group. IL-17A levels were elevated (20.3 pg/ml) in OSAHS group compared to healthy group (10.05 pg/ml). VD levels were negatively correlated with nocturia severity (r = -0.26; P = 0.01) and positively correlated with mean O₂ saturation (r = 0.59; P = 0.02) and lowest O₂ saturation (r = 0.3; P = 0.03). IL-17 levels were positively correlated with nocturia severity (r = 0.24; P = 0.03) and negatively correlated with mean O₂ saturation (r = -0.42; P = 0.03). A significant negative association was observed between IL-7 and VD levels (r = -0.64, P = 0.2 10^-4). The magnitude of this correlation was higher for important nocturia, lower MSaO₂, or higher BMI.

Conclusions: VD deficiency in patients with severe OSAHS is common with a negative association between IL-17 and VD serum levels. Hypoxia could play an important role in this association. Further studies are needed to clarify this relationship.

Keywords: Inflammation; Vitamin D; interleukin-17; obstructive sleep apnea.

Figure 1

Vitamin D and interleukin-17 correlation: (a) all patients; (b) subgroup with mean SaO₂% ≤92%; (c) subgroup with body mass index ≥35; (d) subgroup with nocturia >3; there was a negative significant correlation between Vitamin D and interleukin-17 (P < 10⁻³)