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

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.