The effect of obstructive sleep apnea syndrome on serum S100B and NSE levels: a systematic review and meta-analysis of observational studies

Farzad Rezaei,Mohammad Moslem Imani,Hooshyar Abbasi,Masoud Sadeghi

doi:10.1186/s12890-020-1063-8

Farzad Rezaei, Mohammad Moslem Imani + Show 2 more

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https://doi.org/10.1186/s12890-020-1063-8

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Abstract

BackgroundObstructive sleep apnea syndrome (OSAS) is a common disorder that is accompanied by structural brain changes. This meta-analysis aimed to evaluate the effect of OSAS on the serum levels of astrocytic protein (S100B) and neuron-specific enolase (NSE) in observational studies.MethodsA comprehensive search was performed in the PubMed/Medline, Web of Science, Scopus, ScienceDirect, and Cochrane Library databases to assess the serum level of S100B and/or NSE in patients with OSAS and/or controls. The quality of the study was evaluated by the Newcastle-Ottawa Scale (NOS). A random-effects model was performed using RevMan 5.3 with the mean difference (MD) and 95% confidence intervals (CIs).ResultsOut of 63 studies found in the mentioned databases and one identified by a manual search, nine studies were included and analyzed in this meta-analysis (three cross-sectional and six case-control studies). The analysis showed that the S100B [MD = 53.58 pg/ml, 95%CI: 1.81, 105.35; P = 0.04] and NSE levels [MD = 3.78 ng/ml, 95%CI: 2.07, 5.48; P < 0.0001] were significantly higher in patients than the controls. However, there were no significant differences between the S100B [MD = -28.00 pg/ml, 95%CI: − 79.48, 23.47; P = 0.29] and NSE levels [MD = 0.49 ng/ml, 95%CI: − 0.82, 1.80; P = 0.46].ConclusionsThis meta-analysis found elevated serum S100B and NSE levels in OSAS patients compared to the controls, which suggests that these markers may be used as peripheral indicators of brain damage in OSAS.

Highlights

Obstructive sleep apnea syndrome (OSAS) is a common disorder that is accompanied by structural brain changes
The analysis shows that the Astrocytic protein (S100B) [mean difference (MD) = 53.58 pg/ml, 95%Confidence interval (CI): 1.81, 105.35; P = 0.04, I2 = 98% (P < 0.00001)] and neuron-specific enolase (NSE) levels [MD = 3.78 ng/ml, 95%CI: 2.07, 5.48; P < 0.0001, I2 = 0% (P = 0.44)] were significantly higher in the patients than in the controls
OSAS can cause cellular injury in the central nervous system (CNS) [27]. This metaanalysis shows that the serum S100B and NSE concentrations were significantly elevated in OSAS patients compared with the controls but that no significant changes occurred in the serum S100B and NSE levels of the patients during sleep

Summary

Introduction

Obstructive sleep apnea syndrome (OSAS) is a common disorder that is accompanied by structural brain changes. This meta-analysis aimed to evaluate the effect of OSAS on the serum levels of astrocytic protein (S100B) and neuron-specific enolase (NSE) in observational studies. There is a correlation between OSAS and increased platelet adhesiveness, vascular endothelial dysfunction and Rezaei et al BMC Pulmonary Medicine (2020) 20:31 to neural damage [8]. These markers could serve as sensitive indicators of brain injury development [9]. The appearance of a biochemical marker of cerebral injury could serve as a considerable advantage in OSAS for identifying even small brain injuries and improving the efficacy of treatment [10].

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