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What do changes in concentrations of serum surfactant proteins A and D in OSA mean?

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Abstract

Purpose

Previous studies have shown that surfactant proteins are affected by oxygen concentration and mechanic stretches, although the alteration of serum surfactant proteins in individuals with obstructive sleep apnea (OSA) is still unclear. Therefore, the aim of this study is to examine whether serum concentrations of surfactant proteins A and D are altered and related to hypopnea index (HI) in OSA.

Methods

This is a cross-sectional study. Consecutive 140 males, suspicious of OSA, were studied. OSA was determined by PSG and polysomnographic data examined. Subjects with HI ≥ 10.1/h were classified as higher HI group and those with HI < 10.1/h as lower HI group. Hs-CRP, HbA1C, and FBG were determined by standard methods and Krebs von den Lungen-6 (KL-6), surfactant protein-A (SP-A), and surfactant protein-D (SP-D) by ELISA.

Results

OSA was diagnosed in 110 patients (78.5 %). Mild, moderate, and severe OSA constitutes 26.4, 27.8, and 24.3 %, respectively. Mean age was 44.6 ± 7.65 years. Subjects with higher HI had lower SP-A (139.54. ± 32.94 vs 158.2 ± 38.9 ng/L, p = 0.005) and SP-D (16.54 ± 3.67 vs 18.10 ± 3.48 ng/L, p = 0.014) compared to those with lower HI. Nocturnal HI was strongly correlated with serum levels of SP-A (r = 0.343, p = 0.012) and SP-D (r = 0.504, p < 0.001) and are inversely associated with circulating SP-A and SP-D levels, even after adjusting for age and body mass index in nonsmoking subjects.

Conclusions

Circulating SP-A and SP-D levels are decreased in some individuals with higher HI in OSA, possibly reflecting severity of hypoxia in OSA.

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Abbreviations

OSA:

Obstructive sleep apnea

ATII:

Alveolar type II cells

PSG:

Polysomnography

BMI:

Body mass index

HbA1C:

Hemoglobin A1C

FBG:

Fasting blood glucose

SP-A:

Surfactant protein-A

SP-D:

Surfactant protein-D

KL-6:

Krebs von den Lungen-6

AHI:

Apnea/hypopnea index

HI:

Hypopnea index

AI:

Apnea index

LSaO2 :

Lowest oxyhemoglobin saturation

MSaO2 :

Mean arterial oxygen saturation

ODI3 :

Oxygen desaturation index of 3 %

ODI4 :

Oxygen desaturation index of 4 %

TST90:

The total sleep time with oxyhemoglobin saturation at <90 %

BP:

Blood pressure

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Acknowledgments

The authors wish to thank Professor Alberto Zanchetti and Zhang Qinghua for their constructive expertise. We also thank Dr. Meng Jing, Li Juan, and Cai Li for their invaluable contribution with the distribution and collection of the questionnaire survey. This study was supported by National Natural Science Foundation of China (grant number: 81260017)

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. The Center of Hypertension of the People’s Hospital of Xinjiang Uygur Autonomous Region, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, Tianchi Road No. 91 Tianshan District, Urumqi, 830001, Xinjiang, China

    Shao Liang, Nanfang Li, Mulalibieke Heizhati, Xiaoguang Yao, Arikin Abdireim, Yingchun Wang, Zufeiya Abulikemu, Delian Zhang, Guijuan Chang, Jianqiong Kong, Ling Zhou, Jing Hong, Ting Ying & Yongping Zhang

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  1. Shao Liang
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Correspondence to Nanfang Li.

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Liang, S., Li, N., Heizhati, M. et al. What do changes in concentrations of serum surfactant proteins A and D in OSA mean?. Sleep Breath 19, 955–962 (2015). https://doi.org/10.1007/s11325-014-1106-6

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  • DOI: https://doi.org/10.1007/s11325-014-1106-6

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