Associations between cardiometabolic phenotypes and levels of TNF-α, CRP, and interleukins in obstructive sleep apnea,Sleep and Breathing

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Associations between cardiometabolic phenotypes and levels of TNF-α, CRP, and interleukins in obstructive sleep apnea
Sleep and Breathing ( IF 2.1 ) Pub Date : 2022-08-19 , DOI: 10.1007/s11325-022-02697-w
Quanming Fei _{1,

2,

3} , Yun Tan _{1,

2,

4} , Minhan Yi _{1,

2,

4} , Wangcheng Zhao _{1,

3} , Yuan Zhang _{1,

2}

Affiliation

Purpose

Obstructive sleep apnea (OSA) shows a chronic inflammatory state which is often accompanied by cardiometabolic phenotypes. The aim of this study was to investigate whether or not there were differences of inflammatory proteins levels in patients with OSA with and without a certain phenotype so as to explore the associations between inflammation and additional OSA phenotypes.

Methods

The literature was systematically screened and available data were collected on levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and several interleukins (ILs) in patients with OSA with and without a certain phenotype. Overall effect size of standard mean difference (SMD) was used to compare the expression of differences between the two groups. Data analysis was conducted by Review Manager 5.3, and the threshold of p value was set as < 0.05.

Results

A total of 31 articles were included, covering five traits of obesity, hypertension (HBP), metabolic syndrome (MS), heart disease, and sex. There were elevated levels of TNF-α (SMD = 0.63, p = 0.03), CRP (SMD = 0.64, p = 0.0001), and IL-6 (SMD = 0.83, p = 0.008) levels in OSA with obesity. Also, OSA with HBP showed significant increases of TNF-α (SMD = 0.36, p = 0.02), CRP (SMD = 0.98, p = 0.01), and IL-6 (SMD = 0.76, p < 0.0001) levels. A higher CRP level was also observed in OSA with MS (SMD = 0.31, p = 0.004) and female sex (SMD = 0.21, p = 0.002). There were no statistical differences for IL-1β (p = 0.22) and CRP (p = 0.14) levels of OSA with obesity and heart disease respectively compared with OSA without corresponding phenotype. TNF-α (p = 0.66) and IL-6 (p = 0.49) levels also lacked statistically significant differences between female and male patients with OSA.

Conclusions

Our results revealed that inflammatory proteins TNF-α, CRP, and IL-6 levels were higher in obese and hypertensive patients with OSA and CRP levels were higher in OSA with metabolic syndrome, highlighting a link between inflammation and cardiometabolic complications in patients with OSA.

中文翻译：

阻塞性睡眠呼吸暂停中心脏代谢表型与 TNF-α、CRP 和白细胞介素水平之间的关联

目的

阻塞性睡眠呼吸暂停 (OSA) 显示出一种慢性炎症状态，通常伴有心脏代谢表型。本研究的目的是调查伴有和不伴有特定表型的 OSA 患者的炎症蛋白水平是否存在差异，以探讨炎症与其他 OSA 表型之间的关联。

方法

系统地筛选了文献，并收集了关于伴有和不伴有某种表型的 OSA 患者的肿瘤坏死因子-α (TNF-α)、C 反应蛋白 (CRP) 和几种白细胞介素 (IL) 水平的可用数据。采用标准均数差（SMD）的总体效应量比较两组间表达差异。数据分析由Review Manager 5.3进行，p值阈值设置为<0.05。

结果

共纳入 31 篇文章，涵盖肥胖、高血压（HBP）、代谢综合征（MS）、心脏病和性别五项性状。在伴有肥胖的 OSA 患者中， TNF-α（SMD = 0.63， p = 0.03）、CRP（SMD = 0.64，p = 0.0001）和 IL-6（SMD = 0.83，p = 0.008）水平升高。此外，伴有 HBP 的 OSA 显示 TNF-α（SMD = 0.36， p = 0.02）、CRP（SMD = 0.98，p = 0.01）和 IL-6（SMD = 0.76，p < 0.0001）水平显着增加。在患有 MS (SMD = 0.31, p = 0.004) 和女性 (SMD = 0.21, p = 0.002)的 OSA 中也观察到更高的 CRP 水平。IL-1β 没有统计学差异 ( p = 0.22) 和 CRP ( p = 0.14) 分别与没有相应表型的 OSA 相比，肥胖和心脏病的 OSA 水平。TNF-α ( p = 0.66) 和 IL-6 ( p = 0.49) 水平在女性和男性 OSA 患者之间也缺乏统计学上的显着差异。