Abstract
Hypoxia is linked to an inflammatory imbalance in obstructive sleep apnea syndrome (OSAS). Circulating soluble tumor necrosis factor (TNF)-like weak inducer of apoptosis (sTWEAK) is a cytokine that regulates inflammation and insulin resistance in adipose tissue. This study first investigated sTWEAK concentrations in patients OSAS and evaluated associations between sTWEAK concentrations and visceral adiposity, metabolic dysfunction, and hypoxia observed in OSAS. Forty age, sex, and body mass index-matched patients with simple habitual snoring (HSS) and 70 patients with OSAS were included. Patients were divided according to OSAS severity: mild-moderate (apnea–hypopnea index, AHI 5–30 events/h) and severe (AHI ≥ 30 events/h). Anthropometric data, glucose metabolism, visceral fat (VF) ratio, and sTWEAK levels were compared. sTWEAK levels were higher in the OSAS group than in the HSS group (931.23 ± 136.48 vs. 735.22 ± 102.84 ng/L, p = 0.001). sTWEAK levels were higher in severe OSAS than in mild-moderate OSAS (1031.83 ± 146.69 vs. 891.01 ± 110.01 ng/L, p = 0.002. When we evaluated the sTWEAK value and AHI, VF ratio, total cholesterol, blood pressure, homeostasis model of assessment-insulin resistance, and high-sensitivity C-reactive protein using multiple regression analysis, a significant correlation was found between sTWEAK levels and AHI (p < 0.001). It was found that sTWEAK levels were not correlated with glucose metabolism and VF ratio. Increased circulating sTWEAK levels were associated with the severity of OSAS. High sTWEAK levels were correlated with increased AHI. sTWEAK concentrations are linked to severe OSAS.
Highlights
Hypoxia is linked to an inflammatory imbalance in obstructive sleep apnea syndrome (OSAS)
The visceral fat (VF) ratio (13.30 ± 3.31 vs. 10.51 ± 1.67%) was high in the OSAS group compared with the HSS group (p < 0.05). soluble Tumor necrosis factor-related weak inducer of apoptosis (TWEAK) (sTWEAK) levels were high in the OSAS group compared with the HSS group (931.23 ± 136.48 vs. 735.22 ± 102.84 ng/L, p = 0.001) (Table 1)
Triglyceride, insulin, HOMA-Insulin resistance (IR), and hs-CRP values were similar between the severe and mild-moderate OSAS groups (p > 0.05). sTWEAK levels were high in the severe OSAS group compared with the mild-moderate OSAS group (1031.83 ± 146.69 vs. 891.01 ± 110.01 ng/L, p = 0.002) (Table 1)
Summary
Hypoxia is linked to an inflammatory imbalance in obstructive sleep apnea syndrome (OSAS). When we evaluated the sTWEAK value and AHI, VF ratio, total cholesterol, blood pressure, homeostasis model of assessment-insulin resistance, and high-sensitivity C-reactive protein using multiple regression analysis, a significant correlation was found between sTWEAK levels and AHI (p < 0.001). Increased circulating sTWEAK levels were associated with the severity of OSAS. Abbreviations AHI Apnea/hypopnea index BMI Body mass index HDL-C High-density lipoprotein cholesterol HOMA-IR Homeostasis model of assessment-insulin resistance LDL-C Low-density lipoprotein cholesterol OSAS Obstructive sleep apnoea syndrome WHR Waist hip ratio HSS Habitual simple snoring. The TWEAK gene is located on the 17p13.1 chromosome, encoding a transmembrane protein that can co-express both membrane and soluble T WEAK3. Circulating soluble TWEAK (sTWEAK) is expressed in various cells such as in the intestine, tumor cell lines, liver, skeletal muscle, pancreas, and adipose tissue; Fn14 expression does not occur in healthy tissues under normal conditions[5]. Fn14 expression is immediately stimulated in injured tissues, including skeletal muscle, heart, kidney, liver, and atherosclerotic v essels[2,3,4,5]
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