Nocturnal Continuous Positive Airway Pressure (nCPAP)‎ Decreases High-Sensitivity C-Reactive Protein (hs-CRP)‎ in Obstructive Sleep Apnea-Hypopnea Syndrome

الملخص EN

Background.

Systemic and airway inflammation has recently been linked to obstructive sleep apnea-hypopnea syndrome (OSAHS) and is considered to be a probable risk factor for OSAHS-induced cardiovascular damage.

High-sensitivity C-reactive protein (hs-CRP), as an inflammatory mediator, may be useful for the prediction of the risk of cardiovascular disease (CVD) and assessment of nocturnal continuous positive airway pressure (nCPAP) therapy effect in OSAHS patients.

Methods.

A prospective, controlled, cross-sectional study was conducted on 64 consecutive adult subjects with suspected sleep-disordered breathing (SDB).

Results.

OSAHS was confirmed in 43 patients (24 normotensive and 19 hypertensive patients) and ruled out in 21 normotensive subjects (controls).

The median plasma level of hs-CRP did not differ significantly between OSAHS patients and controls.

It showed an unmarked rise with the severity of OSAHS (p=0.20) and was not correlated with AHI (p=0.067; r=0.28).

After adjusting for cervical perimeter (CP), waist-to-hip ratio (WHR), and blood sugar level, hs-CRP level of 1 mg/dL or greater was significantly more often observed in OSAHS patients compared with controls (p=0.032; OR=5.60) and was also significantly associated with AHI (p=0.021).

A significant decrease in the median plasma hs-CRP level was observed in CPAP compliant patients (p=0.006).

Of those, only normotensive patients showed a significant decrease in plasma hs-CRP level.

In hypertensive ones, however, the hs-CRP level dropped but not significantly.

Using a linear regression model, the change in hs-CRP level (Δhs-CRP) following a 6-month-nCPAP therapy was found to positively correlate with the baseline hs-CRP level for both hypertensive (p=0.02; r=0.68), and even more normotensive OSAHS patients (p<0.0001; r=0.89).

Conclusion.

nCPAP therapy may have a cardiovascular protective effect in OSAHS patients.

hs-CRP level would be useful as a valuable predictor of success in OSAHS treatment monitoring.