Oxidative stress mediated arterial dysfunction in patients with obstructive sleep apnoea and the effect of continuous positive airway pressure treatment.
Oxidative stress mediated arterial dysfunction in patients with obstructive sleep apnoea and the effect of continuous positive airway pressure treatment.
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DOI：
10.1186/1471-2466-12-36
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发表时间：
2012-07-23
影响因子：
3.1
通讯作者：
Angelico F
中科院分区：
文献类型：
--
作者：
Del Ben M;Fabiani M;Loffredo L;Polimeni L;Carnevale R;Baratta F;Brunori M;Albanese F;Augelletti T;Violi F;Angelico F
一些研究表明，阻塞性睡眠呼吸暂停综合征（OSAS）的氧化应激增加和内皮功能降低。我们评估了OSAS、内皮功能障碍和氧化应激之间的关系。进一步的目的是评估鼻持续气道正压通气（nCPAP）对氧化应激和动脉功能障碍的影响。我们连续研究了138例重度打鼾和可能的OSAS患者。患者接受了无人值守的夜间家庭多导睡眠图。10例重度OSAS患者在nCPAP治疗6个月后进行再评估。为了评估体内氧化应激，我们测定了尿8-iso-PGF 2 α和血清可溶性NOX 2衍生肽（sNOX 2-dp）水平。血清中的亚硝酸盐/硝酸盐（NOx）水平也进行了测定。测定血流介导的肱动脉舒张（FMD）以评估内皮功能。重度OSAS患者尿8-iso-PGF 2 α（p<0.001）和血清NO X2水平升高，NO X2水平降低。FMD与OSA严重程度呈负相关。呼吸暂停/低通气指数与中心性肥胖指数及尿8-异前列腺素呈显著相关（r=0.298，P<0.001）。代谢综合征（t=-4.63，p<0.001）和尿8-异前列腺素（t=-2.02，p<0.05）是FMD的唯一独立预测因子。nCPAP治疗6个月后，观察到血清NOX 2（p<0.005）和尿8-iso-PGF 2 α（p<0.01）显著降低，而血清NOx仅轻微升高。观察到FMD的统计学显著增加（从3.6%增加到7.0%）。我们的研究结果表明，患有OSAS和心脏代谢合并症的患者氧化应激和动脉功能障碍增加，nCPAP治疗可部分逆转。
Several studies suggest an increase of oxidative stress and a reduction of endothelial function in obstructive sleep apnoea syndrome (OSAS). We assessed the association between OSAS, endothelial dysfunction and oxidative stress. Further aim was to evaluate the effect of nasal continuous positive airway pressure (nCPAP) on oxidative stress and arterial dysfunction. We studied 138 consecutive patients with heavy snoring and possible OSAS. Patients underwent unattended overnight home polysomnography. Ten patients with severe OSAS were revaluated after 6 months of nCPAP therapy. To assess oxidative stress in vivo, we measured urinary 8-iso-PGF2α and serum levels of soluble NOX2-derived peptide (sNOX2-dp). Serum levels of nitrite/nitrate (NOx) were also determined. Flow-mediated brachial artery dilation (FMD) was measured to asses endothelial function. Patients with severe OSAS had higher urinary 8-iso-PGF2α (p<0.001) and serum NOX2 and lower NOx. A negative association was observed between FMD and OSA severity. Apnea/hypopnea index was significantly correlated with the indices of central obesity and with urinary 8-isoprostanes (r=0.298, p<0.001). The metabolic syndrome (t=-4.63, p<0.001) and urinary 8-isoprostanes (t=-2.02, p<0.05) were the only independent predictors of FMD. After 6-months nCPAP treatment, a significant decrease of serum NOX2, (p<0.005) and urinary 8-iso-PGF2α (p<0.01) was observed, while serum NOx showed only a minor increase. A statistically significant increase of FMD was observed (from 3.6% to 7.0%). The results of our study indicate that patients with OSAS and cardiometabolic comorbidities have increased oxidative stress and arterial dysfunction that are partially reversed by nCPAP treatment.