PDF(Pubmed)
Abstract：
The coexistence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) in a single individual, also known as overlap syndrome (OVS), is associated with higher cardiovascular risk and mortality than either OSA or COPD alone. However, the underlying mechanisms remain unclear. We hypothesized that patients with OVS have elevated systemic inflammatory biomarkers relative to patients with either disease alone, which could explain greater cardiovascular risk observed in OVS.
We included 255 participants in the study, 55 with COPD alone, 100 with OSA alone, 50 with OVS, and 50 healthy controls. All participants underwent a home sleep study, spirometry, and a blood draw for high-sensitivity C-reactive protein and total blood count analysis. In a randomly selected subset of 186 participants, inflammatory protein profiling was performed using Bio-Rad Bio-Plex Pro Human Cytokine 27-Plex Assays. Biomarker level differences across groups were identified using a mixed linear model.
Levels of interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and granulocyte colony stimulating factor (G-CSF) were higher in participants with OVS and COPD compared with healthy controls and participants with OSA. Furthermore, participants with OVS had higher circulating levels of leukocytes and neutrophils than those with COPD, OSA, and controls.
COPD and OVS are associated with higher systemic inflammation relative to OSA and healthy controls. This work proposes the potential utilization of interleukin 6, granulocyte colony stimulating factor, and high-sensitivity C-reactive protein as screening biomarkers for COPD in patients with OSA. Inflammatory pathways may not fully explain the higher cardiovascular risk observed in OVS, indicating the need for further investigation.
Sanchez-Azofra A, Gu W, Masso-Silva JA, et al. Inflammation biomarkers in OSA, chronic obstructive pulmonary disease, and chronic obstructive pulmonary disease/OSA overlap syndrome. J Clin Sleep Med. 2023;19(8):1447-1456.
We included 255 participants in the study, 55 with COPD alone, 100 with OSA alone, 50 with OVS, and 50 healthy controls. All participants underwent a home sleep study, spirometry, and a blood draw for high-sensitivity C-reactive protein and total blood count analysis. In a randomly selected subset of 186 participants, inflammatory protein profiling was performed using Bio-Rad Bio-Plex Pro Human Cytokine 27-Plex Assays. Biomarker level differences across groups were identified using a mixed linear model.
Levels of interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and granulocyte colony stimulating factor (G-CSF) were higher in participants with OVS and COPD compared with healthy controls and participants with OSA. Furthermore, participants with OVS had higher circulating levels of leukocytes and neutrophils than those with COPD, OSA, and controls.
COPD and OVS are associated with higher systemic inflammation relative to OSA and healthy controls. This work proposes the potential utilization of interleukin 6, granulocyte colony stimulating factor, and high-sensitivity C-reactive protein as screening biomarkers for COPD in patients with OSA. Inflammatory pathways may not fully explain the higher cardiovascular risk observed in OVS, indicating the need for further investigation.
Sanchez-Azofra A, Gu W, Masso-Silva JA, et al. Inflammation biomarkers in OSA, chronic obstructive pulmonary disease, and chronic obstructive pulmonary disease/OSA overlap syndrome. J Clin Sleep Med. 2023;19(8):1447-1456.
摘要：
目的：阻塞性睡眠呼吸暂停（OSA）和慢性阻塞性肺疾病（COPD）在单个个体中共存，也称为重叠综合征（OVS），与单纯OSA或COPD相比，心血管风险和死亡率更高。然而,潜在机制尚不清楚.我们假设OVS患者相对于单独患有任一种疾病的患者具有升高的全身性炎症生物标志物,这可以解释在OVS中观察到的更大的心血管风险。
方法：我们纳入了255名参与者，55仅COPD，100只OSA，50与OVS，和50个健康对照。所有参与者都接受了家庭睡眠研究，肺活量测定,抽血进行hs-CRP和总血细胞计数分析。在随机选择的186名参与者的子集中，使用Bio-RadBio-PlexPro人类细胞因子27-Plex测定法进行炎性蛋白谱分析.使用混合线性模型鉴定各组间的生物标志物水平差异。
结果：白细胞介素6（IL-6）水平，高敏C反应蛋白(hs-CRP)和粒细胞集落刺激因子(G-CSF),与健康对照组和OSA参与者相比，OVS和COPD参与者的比例更高。此外，OVS参与者的白细胞和中性粒细胞的循环水平高于COPD，OSA和控制。
结论：与OSA和健康对照相比，COPD和OVS与更高的全身性炎症相关。这项工作提出了IL-6，G-CSF的潜在利用，和hs-CRP作为OSA患者COPD的筛查生物标志物。炎症途径可能不能完全解释OVS中观察到的更高的心血管风险，表明需要进一步调查。
方法：我们纳入了255名参与者，55仅COPD，100只OSA，50与OVS，和50个健康对照。所有参与者都接受了家庭睡眠研究，肺活量测定,抽血进行hs-CRP和总血细胞计数分析。在随机选择的186名参与者的子集中，使用Bio-RadBio-PlexPro人类细胞因子27-Plex测定法进行炎性蛋白谱分析.使用混合线性模型鉴定各组间的生物标志物水平差异。
结果：白细胞介素6（IL-6）水平，高敏C反应蛋白(hs-CRP)和粒细胞集落刺激因子(G-CSF),与健康对照组和OSA参与者相比，OVS和COPD参与者的比例更高。此外，OVS参与者的白细胞和中性粒细胞的循环水平高于COPD，OSA和控制。
结论：与OSA和健康对照相比，COPD和OVS与更高的全身性炎症相关。这项工作提出了IL-6，G-CSF的潜在利用，和hs-CRP作为OSA患者COPD的筛查生物标志物。炎症途径可能不能完全解释OVS中观察到的更高的心血管风险，表明需要进一步调查。
