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Free Content The activation of the inflammatory cytokines in overweight patients with mild obstructive sleep apnoea

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It is widely accepted that obstructive sleep apnoea (OSA) is linked with cardiovascular diseases. The relationship is complex and remains still poorly understood. The presence of chronic systemic inflammation has been connected with pathogenesis of both OSA and cardiovascular diseases. While atherogenesis is believed to be a process of many years, little is known about the potential impact of the largest OSA subgroup, mild OSA, on the development of cardiovascular diseases. The aim of the present study was to assess whether untreated mild OSA is associated with an activation of inflammatory cytokine system. The adult study population consisted of two groups: 84 patients with mild OSA [apnoea–hypopnoea index (AHI) 5–15 h−1] and 40 controls (AHI <5 h−1). Serum concentrations of pro- and anti-inflammatory cytokines were measured before any interventions. After adjustments for age, sex, body mass index, fat percentage, most important cardiometabolic and inflammatory diseases, and non-steroidal anti-inflammatory medication, the mean level of tumour necrosis factor-α was significantly elevated (1.54 versus 1.17 pg mL−1, P =0.004), whereas the level of interleukin-1β (IL-1β) was reduced (0.19 versus 0.23 pg mL−1, P =0.004) in patients with mild OSA compared with controls. The concentrations of the protective anti-inflammatory cytokines, interleukin-10 (1.28 versus 0.70 pg mL−1, P <0.001) and interleukin-1 receptor antagonist (478 versus 330 pg mL−1, P =0.003) were elevated in the OSA group. The concentrations of C-reactive protein increased, but IL-1β decreased along with the increase of AHI. Mild OSA was found to be associated not only with the activation of the pro-inflammatory, but also with the anti-inflammatory systems.
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Keywords: C-reactive protein; cytokines; inflammation; obstructive; sleep apnoea

Document Type: Research Article

Affiliations: 1: Department of Otorhinolaryngology, Institute of Clinical Medicine, Kuopio University Hospital and University of Kuopio, Kuopio, Finland 2: Department of Internal Medicine, Institute of Clinical Medicine, Kuopio University Hospital and University of Kuopio, Kuopio, Finland 3: Department of Health Promotion and Chronic Diseases Prevention, National Institute for Health and Welfare, Helsinki, Finland 4: Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany 5: Eastern Finland Laboratory Centre (ISLAB), OK Kuopio, Finland 6: Department of Clinical Physiology and Nuclear Medicine, Institute of Clinical Medicine, Kuopio University Hospital and University of Kuopio, Kuopio, Finland 7: School of Public Health and Clinical Nutrition, University of Kuopio, Kuopio, Finland 8: Skogby Sleep Clinic, Rinnekoti Research Center, Espoo, and Department of Neurology, University of Helsinki, Helsinki, Finland

Publication date: 2010-06-01

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