Putative associations between inflammatory biomarkers, obesity, and obstructive sleep apnea

Abstract

Background: Previous studies have reported increased levels of inflammatory mediators in patients with obstructive sleep apnea (OSA), but their relation with the severity of OSA is controversial.

Objective: To address potential relationships between OSA-related inflammatory markers, namely, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and fibrinogen, with different oxygenation parameters and with BMI.

Methods: All eligible patients with suspected OSA newly referred to the Sleep Medicine Research Center at King Abdulaziz University Hospital, Jeddah, were evaluated demographically and anthropometrically, and underwent overnight polysomnography. Fasting morning blood samples were collected to measure serum levels of CRP, fibrinogen, TNF-α, and IL-6. Potential correlations between these inflammatory mediators and severity measures of OSA and body mass index (BMI) were explored.

Results: Sixty-four patients completed the study (40 with OSA and 24 without OSA). Significantly increased levels of CRP, fibrinogen, IL-6, and TNF-α emerged in patients with OSA compared to non-OSA. Significant associations between log CRP and log fibrinogen levels emerged with increasing BMI. However, there was no significant association between any of the inflammatory markers and the severity of OSA based on the apnea/hypopnea index or oxyhemoglobin saturation-derived parameters.

Conclusions: OSA patients exhibit increased levels of inflammatory mediators that do not appear to be associated with polysomnographic measures, but exhibit positive correlation with the degree of adiposity.

Keywords: C-reactive protein; SpO2; fibrinogen; inflammation; interleukin-6; obstructive sleep apnea; tumor necrosis factor-alpha.