Author/Authors :
Msaad , Sameh Department of Respiratory and Sleep Medicine - Hédi Chaker University Hospital of Sfax, Tunisia , Chaabouni, Akram Department of Biochemistry - Hédi Chaker University Hospital of Sfax, Tunisia , Marrakchi, Rim Department of Biochemistry - Hédi Chaker University Hospital of Sfax, Tunisia , Boudaya, Mariem University of Sfax - Faculty of Medicine of Sfax, Tunisia , Kotti, Amina Department of Respiratory and Sleep Medicine - Hédi Chaker University Hospital of Sfax, Tunisia , Feki, Walid Department of Respiratory and Sleep Medicine - Hédi Chaker University Hospital of Sfax, Tunisia , Jamoussi, Kamel University of Sfax - Faculty of Medicine of Sfax, Tunisia , Kammoun, Samy Department of Respiratory and Sleep Medicine - Hédi Chaker University Hospital of Sfax, Tunisia
Abstract :
Background. Systemic and airway inflam mation has recently been linked to obstructive sleep apnea-hypopnea syndrome (OSAHS) and is considered to be a probable risk factor for OSAHS-induced cardiovascular damage. High-sensitivity C-reactive protein (hsCRP), as an inflammatory mediator, may be useful for the prediction of the risk of cardiovascular disease (CVD) and assessment of nocturnal continuous positive airway pressure (nCPAP) therapy effect in OSAHS patients. Methods. A prospective, controlled, cross-sectional study was conducted on 64 consecutive adult subjects with suspected sleep-disordered breathing (SDB). Results. OSAHS was confirmed in 43 patients (24 normotensive and 19 hypertensive patients) and ruled out in 21 normotensive subjects (controls). The median plasma level of hs-CRP did not differ significantly between OSAHS patients and controls. It showed an
unmarked rise with the severity of OSAHS (p = 0:20) and was not correlated with AHI (p = 0:067; r = 0:28). After adjusting for cervical perimeter (CP), waist-to-hip ratio (WHR), and blood sugar level, hs-CRP level of 1 mg/dL or greater was significantly more often observed in OSAHS patients compared with controls (p = 0:032; or = 5:60) and was also significantly associated
with AHI (p = 0:021). A significant decrease in the median plasma hs-CRP level was observed in CPAP compliant patients (p = 0:006). Of those, only normotensive patients showed a significant decrease in plasma hs-CRP level. In hypertensive ones, however, the hs-CRP level dropped but not significantly. Using a linear regression model, the change in hs-CRP level (ΔhsCRP) following a 6-month-nCPAP therapy was found to positively correlate with the baseline hs-CRP level for both
hypertensive (p = 0:02; r = 0:68), and even more normotensive OSAHS patients (p < 0:0001; r = 0:89). Conclusion. nCPAP therapy may have a cardiovascular protective effect in OSAHS patients. hs-CRP level would be useful as a valuable predictor of success in OSAHS treatment monitoring
Keywords :
Nocturnal Continuous , Positive Airway Pressure (nCPAP) , Obstructive Sleep Apnea-Hypopnea Syndrome , Decreases High-Sensitivity , C-Reactive Protein (hs-CRP)
