Inflammation biomarkers in OSA, chronic obstructive pulmonary disease, and chronic obstructive pulmonary disease/OSA overlap syndrome

作者：Ana Sanchez-Azofra, W. Gu, J. Masso-Silva, D. Sánz-Rubio, Marta Marín-Oto, P. Cubero, A. Gil, E. Moya, L. Barnes, O. Mesarwi, T. Marin, T. Simonson, L. C. Crotty Alexander, J. Marin, A. Malhotra · 发表于：Journal of Clinical Sleep Medicine (JCSM) · 年份：2023 · DOI：10.5664/jcsm.10600 · 被引用次数：38 · 研究领域：Medicine

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...