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Observational Study
. 2024 Jan 29;25(1):40.
doi: 10.1186/s12882-024-03472-7.

Association of obstructive sleep apnea and diurnal variation of cystatin C

Seolhyun Lee  1 , Sungryong Noh  2 , Woo Hyun Lee  3   4
Affiliations
Observational Study

Association of obstructive sleep apnea and diurnal variation of cystatin C

Seolhyun Lee et al. BMC Nephrol. .

Abstract

Purpose: Obstructive sleep apnea is a known risk factor for the progression of chronic kidney disease. To find early signs of the progression in subjects with obstructive sleep apnea., we assessed the diurnal variation of kidney biomarkers.

Methods: A prospective observational study was conducted at Kangwon National University Hospital, Chuncheon, South Korea. All participants underwent in-laboratory polysomnography and phlebotomy in the evening before the polysomnography and in the morning after the polysomnography. Kidney biomarkers, including serum creatinine, blood urea nitrogen, and serum cystatin C, were measured. Delta kidney biomarkers were calculated by subtracting the evening level of the biomarkers from the morning level.

Results: Twenty-six of 50 participants had severe obstructive sleep apnea. Delta cystatin C was significantly correlated with apnea-hypopnea index, oxygen desaturation index, and total arousal index with coefficients of -0.314, -0.323, and -0.289, respectively. In participants without severe obstructive sleep apnea, the morning cystatin C level (0.84 ± 0.11 mg/L) was significantly higher than the evening cystatin C level (0.81 ± 0.11 mg/L) (P = 0.005). With severe obstructive sleep apnea, the cystatin C levels were not different between the morning (0.85 ± 0.11 mg/L) and the evening (0.85 ± 0.10 mg/L).

Conclusions: Cystatin C level was increased in the morning in participants without severe obstructive sleep apnea, but not in participants with severe obstructive sleep apnea.

Keywords: Chronic kidney disease; Circadian rhythm; Cystatin C; Diurnal variation; Nocturnal hypertension; Obstructive sleep apnea.

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Conflict of interest statement

Competing interests. The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Differences in Cystatin C level Differences of cystatin C levels from the morning level to the evening level in each subject. The blue circles depict subjects with severe OSA (AHI >30) and the orange circles depict subjects without severe OSA (AHI ≤ 30). X marks denote the mean value for each group. OSA, obstructive sleep apnea; AHI, apnea-hypopnea index
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