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Paraoxonase Activity in Patients with Obstructive Sleep Apnea: a Systematic Review and Meta-analysis

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Abstract

Obstructive sleep apnea (OSA) is a common sleep disorder affecting high proportion of the population. This disorder is associated with an increase in the oxidative stress and cardiovascular disease. Paraoxonase (PON) is a lipolactonase enzyme removing toxic lipids and decreasing lipoprotein oxidation. The present study was conducted to reassess possible alternation of PON activities in OSA patients. Studies measured PON activities in OSA were searched in PubMed, Scopus, EMBASE, Web of Science databases, and Cochrane Library from January 1990 to February 2019. Screening of the studies was performed by two authors independently according to title, abstract, and full text. Quality of studies was assessed by Newcastle-Ottawa Quality Assessment Scale, and random-effect model was used for evaluating the effect of OSA on PON activities. A total of 97 records were found in searching, 39 duplicated records were removed, and 5 studies for PON activity and 2 studies for aryl-esterase (ARE) activity were included in the meta-analysis. Pooled analysis showed no significant difference in terms of PON activity between OSA and control groups (p = 0.434). Similarly, ARE demonstrated no significant difference between OSA and control groups (p = 0.515). Subgroup meta-analysis according to age, BMI, AHI, and diagnosis criteria demonstrated no significant difference between two groups. The results of this study indicated no association between OSA and PON activities as an antioxidant enzyme. However, a relatively low number of studies limited us to conclude a definite conclusion; therefore, more studies are needed in this regard.

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References

  1. Lurie A. Obstructive sleep apnea in adults: epidemiology, clinical presentation, and treatment options. Adv Cardiol. 2011;46:1–42. https://doi.org/10.1159/000327660.

    Article  Google Scholar 

  2. Khazaie H, Najafi F, Rezaie L, Tahmasian M, Sepehry AA, Herth FJ. Prevalence of symptoms and risk of obstructive sleep apnea syndrome in the general population. Arch Iran Med. 2011;14(5):335–8.

    PubMed  Google Scholar 

  3. Dempsey JA, Veasey SC, Morgan BJ, O'Donnell CP. Pathophysiology of sleep apnea. Physiol Rev. 2010;90(1):47–112. https://doi.org/10.1152/physrev.00043.2008.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Shahveisi K, Jalali A, Moloudi MR, Moradi S, Maroufi A, Khazaie H. Sleep architecture in patients with primary snoring and obstructive sleep apnea. Basic Clin Neurosci. 2018;9(2):147–56. https://doi.org/10.29252/NIRP.BCN.9.2.147.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Drager LF, Polotsky VY, Lorenzi-Filho G. Obstructive sleep apnea: an emerging risk factor for atherosclerosis. Chest. 2011;140(2):534–42. https://doi.org/10.1378/chest.10-2223.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Levy P, Kohler M, McNicholas WT, Barbe F, McEvoy RD, Somers VK, et al. Obstructive sleep apnoea syndrome. Nat Rev Dis Prim. 2015;1:15015. https://doi.org/10.1038/nrdp.2015.15.

    Article  PubMed  Google Scholar 

  7. Schieber M, Chandel NS. ROS function in redox signaling and oxidative stress. Curr Biol. 2014;24(10):R453–R62. https://doi.org/10.1016/j.cub.2014.03.034.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Yang X, Li Y, Li Y, Ren X, Zhang X, Hu D, et al. Oxidative stress-mediated atherosclerosis: mechanisms and therapies. Front Physiol. 2017;8:600. https://doi.org/10.3389/fphys.2017.00600.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Chistiakov DA, Melnichenko AA, Myasoedova VA, Grechko AV, Orekhov AN. Mechanisms of foam cell formation in atherosclerosis. J Mol Med (Berl). 2017;95(11):1153–65. https://doi.org/10.1007/s00109-017-1575-8.

    Article  CAS  Google Scholar 

  10. Birben E, Sahiner UM, Sackesen C, Erzurum S, Kalayci O. Oxidative stress and antioxidant defense. World Allergy Organ J. 2012;5(1):9–19. https://doi.org/10.1097/WOX.0b013e3182439613.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Mackness M, Mackness B. Human paraoxonase-1 (PON1): gene structure and expression, promiscuous activities and multiple physiological roles. Gene. 2015;567(1):12–21. https://doi.org/10.1016/j.gene.2015.04.088.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Mahrooz A. Pharmacological interactions of paraoxonase 1 (PON1): a HDL-bound antiatherogenic enzyme. Curr Clin Pharmacol. 2016;11(4):259–64.

    Article  CAS  PubMed  Google Scholar 

  13. Litvinov D, Mahini H, Garelnabi M. Antioxidant and anti-inflammatory role of paraoxonase 1: implication in arteriosclerosis diseases. N Am J Med Sci. 2012;4(11):523–32. https://doi.org/10.4103/1947-2714.103310.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lira AB, de Sousa Rodrigues CF. Evaluation of oxidative stress markers in obstructive sleep apnea syndrome and additional antioxidant therapy: a review article. Sleep Breath. 2016;20(4):1155–60. https://doi.org/10.1007/s11325-016-1367-3.

    Article  PubMed  Google Scholar 

  15. Eisele HJ, Markart P, Schulz R. Obstructive sleep apnea, oxidative stress, and cardiovascular disease: evidence from human studies. Oxidative Med Cell Longev. 2015;2015:608438. https://doi.org/10.1155/2015/608438.

    Article  CAS  Google Scholar 

  16. Okur HK, Pelin Z, Yuksel M, Yosunkaya S. Lipid peroxidation and paraoxonase activity in nocturnal cyclic and sustained intermittent hypoxia. Sleep Breath. 2013;17(1):365–71. https://doi.org/10.1007/s11325-012-0703-5.

    Article  PubMed  Google Scholar 

  17. Andaku DK, D'Almeida V, Carneiro G, Hix S, Tufik S, Togeiro SM. Sleepiness, inflammation and oxidative stress markers in middle-aged males with obstructive sleep apnea without metabolic syndrome: a cross-sectional study. Respir Res. 2015;16(1):3. https://doi.org/10.1186/s12931-015-0166-x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Vatansever E, Surmen-Gur E, Ursavas A, Karadag M. Obstructive sleep apnea causes oxidative damage to plasma lipids and proteins and decreases adiponectin levels. Sleep Breath. 2011;15(3):275–82. https://doi.org/10.1007/s11325-010-0378-8.

    Article  PubMed  Google Scholar 

  20. Andaku DK, D'Almeida V, Carneiro G, Hix S, Tufik S, Togeiro SM. Sleepiness, inflammation and oxidative stress markers in middle-aged males with obstructive sleep apnea without metabolic syndrome: a cross-sectional study. Respir Res. 2015;16(1). https://doi.org/10.1186/s12931-015-0166-x.

  21. Kim J, Lee S, In K, Kim J, You S, Kang K, et al. Increase in serum haptoglobin and apolipoprotein M in patients with obstructive sleep apnoea. J Sleep Res. 2009;18(3):313–20. https://doi.org/10.1111/j.1365-2869.2008.00725.x.

    Article  PubMed  Google Scholar 

  22. Baysal E, Taysi S, Aksoy N, Uyar M, Celenk F, Karatas ZA, et al. Serum paraoxonase, arylesterase activity and oxidative status in patients with obstructive sleep apnea syndrome (OSAS). Eur Rev Med Pharmacol Sci. 2012;16(6):770–4.

    CAS  PubMed  Google Scholar 

  23. Dyugovskaya L, Lavie P, Lavie L. Increased adhesion molecules expression and production of reactive oxygen species in leukocytes of sleep apnea patients. Am J Respir Crit Care Med. 2002;165(7):934–9. https://doi.org/10.1164/ajrccm.165.7.2104126.

    Article  PubMed  Google Scholar 

  24. Asker S, Asker M, Sarikaya E, Sunnetcioglu A, Aslan M, Demir H. Oxidative stress parameters and their correlation with clinical, metabolic and polysomnographic parameters in severe obstructive sleep apnea syndrome. Int J Clin Exp Med. 2015;8(7):11449–55.

    PubMed  PubMed Central  Google Scholar 

  25. Kota SK, Meher LK, Kota SK, Jammula S, Krishna SVS, Modi KD. Implications of serum paraoxonase activity in obesity, diabetes mellitus, and dyslipidemia. Indian J Endocrinol Metab. 2013;17(3):402–12. https://doi.org/10.4103/2230-8210.111618.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Correspondence to Habibolah Khazaie.

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Fadaei, R., Safari-Faramani, R., Rezaei, M. et al. Paraoxonase Activity in Patients with Obstructive Sleep Apnea: a Systematic Review and Meta-analysis. SN Compr. Clin. Med. 2, 25–31 (2020). https://doi.org/10.1007/s42399-019-00202-1

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