Abstract
Aim We aimed to investigate the relationship between serum pregnancy-associated plasma protein A (PAPP-A) levels and obstructive sleep apnea syndrome (OSAS). Materials and Method 44 patients with OSAS and 44 healthy adults were included in this study. The participants having rheumatic or systemic inflammatory disease, advanced liver or kidney failure, diabetes, heart failure, hypertension, pregnancy, prerenal azotemia, known history of coronary artery disease, any pulmonary disease, rhinitis, or atopy, history of major trauma or surgery within the last six 6 months, and inhaled nasal or systemic corticosteroid use or other anti-inflammatory medications and those with <18 years of age were excluded. Serum PAPP-A levels were determined by the Elisa method with the immune sandwich measuring method. Statistical analysis of the study was performed with SPSS 17.0 statistical analysis package program, and p < 0.05 was considered as significant. Results Serum PAPP-A levels of patients with OSAS (2.350 ng/ml (0.641–4.796)) were significantly higher (p < 0.001) when compared with healthy controls (0.971 ng/ml (0.109–2.679)). There was a statistically significant difference in serum PAPP-A levels between groups of OSAS patients according to the classification of OSAS severity. Between the groups of patients with OSAS, serum levels of PAPP-A in moderate group was significantly higher when compared with severe OSAS group (p < 0.001). There was positive correlations between PAPP-A levels and night minimum (p=0.042, r=0.309), and average oxygen levels (p=0.006, r=0.407). There was a negative correlation between PAPP-A levels and AHI (p=0.002, r=−0.460). Conclusion Higher PAPP-A levels in OSAS patients that were found in this study show inflammatory component in OSAS.
Highlights
Obstructive sleep apnea syndrome (OSAS) is characterized by permanent recurrent obstruction of the upper airways during sleep
We found that pregnancy-associated plasma protein A (PAPP-A) levels were significantly higher in OSAS patients compared to the control group
PAPP-A levels were significantly higher in patients with moderate severity group compared to other groups
Summary
Obstructive sleep apnea syndrome (OSAS) is characterized by permanent recurrent obstruction of the upper airways during sleep. Apnea results in loud snoring or arousal when the airway passage is enable again [1, 2]. The pathogenesis of OSAS could not exactly be clarified, there are studies reporting that chronic inflammation plays a role. Vasoconstriction as a result of endothelial dysfunction and vascular damage, and hypercoagulability-thrombotic tendency occur. In this case, it leads to cardiovascular and cerebrovascular complications in OSAS patients. In people with OSAS, soluble adhesion molecules like intercellular adhesion molecule 1 (ICAM-1), vascular adhesion molecule 1 (VCAM1), and acute phase proteins like C-reactive protein (CRP), interleukin-6 (IL-6), retinol binding protein (RBP), and isoprostane are reported to be high [9, 10]. It is known that many factors such as advanced age, male sex, obesity, medications, genetic factors, airway configuration and diameter, sleep position, upper airway muscle and reflexes, and cytokines contribute to the development of OSAS [11, 12]
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