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The association of oxidative stress with central obesity in obstructive sleep apnea

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Abstract

Purpose

The purpose of this paper is to evaluate concentrations of multiple oxidative stress and antioxidant status markers in patients with obstructive sleep apnea (OSA) and normal controls of comparable obesity.

Methods

A total of 73 male subjects, recruited from a sleep clinic or advertisements, were enrolled in this study. All subjects underwent overnight polysomnography. The subjects were divided into normal control (n = 20), mild to moderate OSA (n = 31), and severe OSA (n = 22) with no difference in obesity. Blood was withdrawn from subjects, and markers of oxidative stress and antioxidant status, and parameters of glucose metabolism were assessed.

Results

There was no significant difference in either oxidative stress or antioxidant status markers among the three groups. There was no significant correlation between the oxidative stress markers and the OSA variables. However, there were correlations between waist-to-hip ratio (WHR)–oxidized low-density lipoprotein cholesterol (oxLDL) (r = 0.424), WHR–glutathione peroxidase (GPX) (r = 0.318), WHR–total antioxidant status (TAS) (r = −0.317), and WHR–superoxide dismutase (SOD) (r = −0.338). In multiple regression analysis, WHR was a significant independent variable of oxLDL, GPX, TAS, and SOD.

Conclusions

The oxidative stress in OSA was related to central obesity rather than intermittent hypoxia or respiratory disturbances. To control cardiovascular complications in OSA, weight reduction should be a component in the treatment strategy.

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References

  1. Partinen M (1995) Epidemiology of obstructive sleep apnea syndrome. Curr Opin Pulm Med 1(6):482–487

    Article  PubMed  CAS  Google Scholar 

  2. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328(17):1230–1235

    Article  PubMed  CAS  Google Scholar 

  3. Kim J, In K, You S, Kang K, Shim J, Lee S, Lee J, Park C, Shin C (2004) Prevalence of sleep-disordered breathing in middle-aged Korean men and women. Am J Respir Crit Care Med 170(10):1108–1113

    Article  PubMed  Google Scholar 

  4. Shahar E, Whitney CW, Redline S, Lee ET, Newman AB, Javier Nieto F, O'Connor GT, Boland LL, Schwartz JE, Samet JM (2001) Sleep-disordered breathing and cardiovascular disease: cross-sectional results of the Sleep Heart Health Study. Am J Respir Crit Care Med 163(1):19–25

    PubMed  CAS  Google Scholar 

  5. Peker Y, Hedner J, Norum J, Kraiczi H, Carlson J (2002) Increased incidence of cardiovascular disease in middle-aged men with obstructive sleep apnea: a 7-year follow-up. Am J Respir Crit Care Med 166(2):159–165

    Article  PubMed  Google Scholar 

  6. Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365(9464):1046–1053

    PubMed  Google Scholar 

  7. McCord JM (1985) Oxygen-derived free radicals in postischemic tissue injury. N Engl J Med 312(3):159–163

    Article  PubMed  CAS  Google Scholar 

  8. Prabhakar NR (2002) Sleep apneas: an oxidative stress? Am J Respir Crit Care Med 165(7):859–860

    PubMed  Google Scholar 

  9. Dean RT, Wilcox I (1993) Possible atherogenic effects of hypoxia during obstructive sleep apnea. Sleep 16(8 Suppl):S15–S21, discussion S21-12

    PubMed  CAS  Google Scholar 

  10. Lavie L, Vishnevsky A, Lavie P (2004) Evidence for lipid peroxidation in obstructive sleep apnea. Sleep 27(1):123–128

    PubMed  Google Scholar 

  11. Minoguchi K, Yokoe T, Tanaka A, Ohta S, Hirano T, Yoshino G, O'Donnell CP, Adachi M (2006) Association between lipid peroxidation and inflammation in obstructive sleep apnoea. Eur Respir J 28(2):378–385

    Article  PubMed  CAS  Google Scholar 

  12. Vatansever E, Surmen-Gur E, Ursavas A, Karadag M (2010) Obstructive sleep apnea causes oxidative damage to plasma lipids and proteins and decreases adiponectin levels. Sleep Breath (in press)

  13. Yamauchi M, Nakano H, Maekawa J, Okamoto Y, Ohnishi Y, Suzuki T, Kimura H (2005) Oxidative stress in obstructive sleep apnea. Chest 127(5):1674–1679

    Article  PubMed  CAS  Google Scholar 

  14. Barcelo A, Barbe F, de la Pena M, Vila M, Perez G, Pierola J, Duran J, Agusti AG (2006) Antioxidant status in patients with sleep apnoea and impact of continuous positive airway pressure treatment. Eur Respir J 27(4):756–760

    Article  PubMed  CAS  Google Scholar 

  15. Christou K, Moulas AN, Pastaka C, Gourgoulianis KI (2003) Antioxidant capacity in obstructive sleep apnea patients. Sleep Med 4(3):225–228

    Article  PubMed  Google Scholar 

  16. Wali SO, Bahammam AS, Massaeli H, Pierce GN, Iliskovic N, Singal PK, Kryger MH (1998) Susceptibility of LDL to oxidative stress in obstructive sleep apnea. Sleep 21(3):290–296

    PubMed  CAS  Google Scholar 

  17. Ozturk L, Mansour B, Yuksel M, Yalcin AS, Celikoglu F, Gokhan N (2003) Lipid peroxidation and osmotic fragility of red blood cells in sleep-apnea patients. Clin Chim Acta 332(1–2):83–88

    Article  PubMed  CAS  Google Scholar 

  18. Svatikova A, Wolk R, Lerman LO, Juncos LA, Greene EL, McConnell JP, Somers VK (2005) Oxidative stress in obstructive sleep apnoea. Eur Heart J 26(22):2435–2439

    Article  PubMed  CAS  Google Scholar 

  19. Tokuda F, Sando Y, Matsui H, Yokoyama T (2009) N epsilon-(hexanoyl) lysine, a new oxidative stress marker, is increased in metabolic syndrome, but not in obstructive sleep apnea. Am J Med Sci 338(2):127–133

    Article  PubMed  Google Scholar 

  20. Olusi SO (2002) Obesity is an independent risk factor for plasma lipid peroxidation and depletion of erythrocyte cytoprotectic enzymes in humans. Int J Obes Relat Metab Disord 26(9):1159–1164

    Article  PubMed  CAS  Google Scholar 

  21. Davi G, Guagnano MT, Ciabattoni G, Basili S, Falco A, Marinopiccoli M, Nutini M, Sensi S, Patrono C (2002) Platelet activation in obese women: role of inflammation and oxidant stress. Jama 288(16):2008–2014

    Article  PubMed  CAS  Google Scholar 

  22. Block G, Dietrich M, Norkus EP, Morrow JD, Hudes M, Caan B, Packer L (2002) Factors associated with oxidative stress in human populations. Am J Epidemiol 156(3):274–285

    Article  PubMed  Google Scholar 

  23. Rechtschaffen A, Kales A (1968) A manual of standardized terminology, technique, and scoring system for sleep stages of human subjects. BIS/BRI, UCLA, Los Angeles

    Google Scholar 

  24. American Academy of Sleep Medicine Task Force (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 22(5):667–689

    Google Scholar 

  25. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 364(9438):937–952

    Article  PubMed  Google Scholar 

  26. Alonso-Fernandez A, Garcia-Rio F, Arias MA, Hernanz A, de la Pena M, Pierola J, Barcelo A, Lopez-Collazo E, Agusti A (2009) Effects of CPAP on oxidative stress and nitrate efficiency in sleep apnoea: a randomised trial. Thorax 64(7):581–586

    Article  PubMed  CAS  Google Scholar 

  27. Urakawa H, Katsuki A, Sumida Y, Gabazza EC, Murashima S, Morioka K, Maruyama N, Kitagawa N, Tanaka T, Hori Y, Nakatani K, Yano Y, Adachi Y (2003) Oxidative stress is associated with adiposity and insulin resistance in men. J Clin Endocrinol Metab 88(10):4673–4676

    Article  PubMed  CAS  Google Scholar 

  28. Keaney JF Jr, Larson MG, Vasan RS, Wilson PW, Lipinska I, Corey D, Massaro JM, Sutherland P, Vita JA, Benjamin EJ (2003) Obesity and systemic oxidative stress: clinical correlates of oxidative stress in the Framingham Study. Arterioscler Thromb Vasc Biol 23(3):434–439

    Article  PubMed  CAS  Google Scholar 

  29. Charles LE, Burchfiel CM, Violanti JM, Fekedulegn D, Slaven JE, Browne RW, Hartley TA, Andrew ME (2008) Adiposity measures and oxidative stress among police officers. Obes Silver Spring 16(11):2489–2497

    Article  CAS  Google Scholar 

  30. Vincent HK, Taylor AG (2006) Biomarkers and potential mechanisms of obesity-induced oxidant stress in humans. Int J Obes Lond 30(3):400–418

    Article  PubMed  CAS  Google Scholar 

  31. Bakker SJ RGIJ, Teerlink T, Westerhoff HV, Gans RO, Heine RJ (2000) Cytosolic triglycerides and oxidative stress in central obesity: the missing link between excessive atherosclerosis, endothelial dysfunction, and beta-cell failure? Atherosclerosis 148(1):17–21

    Article  PubMed  Google Scholar 

  32. Inoguchi T, Li P, Umeda F, Yu HY, Kakimoto M, Imamura M, Aoki T, Etoh T, Hashimoto T, Naruse M, Sano H, Utsumi H, Nawata H (2000) High glucose level and free fatty acid stimulate reactive oxygen species production through protein kinase C–dependent activation of NAD(P)H oxidase in cultured vascular cells. Diabetes 49(11):1939–1945

    Article  PubMed  CAS  Google Scholar 

  33. Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, Ohannesian JP, Marco CC, McKee LJ, Bauer TL, José FC (1996) Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med 334(5):292–295

    Article  PubMed  CAS  Google Scholar 

  34. Bouloumie A, Marumo T, Lafontan M, Busse R (1999) Leptin induces oxidative stress in human endothelial cells. FASEB J 13(10):1231–1238

    PubMed  CAS  Google Scholar 

  35. Frei B, Forte TM, Ames BN, Cross CE (1991) Gas phase oxidants of cigarette smoke induce lipid peroxidation and changes in lipoprotein properties in human blood plasma. Protective effects of ascorbic acid. Biochem J 277(Pt 1):133–138

    PubMed  CAS  Google Scholar 

  36. Morrow JD, Frei B, Longmire AW, Gaziano JM, Lynch SM, Shyr Y, Strauss WE, Oates JA, Roberts LJ 2nd (1995) Increase in circulating products of lipid peroxidation (F2-isoprostanes) in smokers. Smoking as a cause of oxidative damage. N Engl J Med 332(18):1198–1203

    Article  PubMed  CAS  Google Scholar 

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Acknowledgment

This study was supported by grant to 02-2008-007 from the SNUBH Research Fund.

Conflict of interest statement

None of the authors declare a conflict of interest in relation to this work.

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Authors and Affiliations

  1. Department of Neuropsychiatry, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463–707, South Korea

    Sang Don Lee, Gawon Ju, Ji-Ae Choi & In-Young Yoon

  2. Department of Otorhinolaryngology, Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea

    Jeong-Whun Kim

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  1. Sang Don Lee
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  2. Gawon Ju
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Correspondence to In-Young Yoon.

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Lee, S.D., Ju, G., Choi, JA. et al. The association of oxidative stress with central obesity in obstructive sleep apnea. Sleep Breath 16, 511–517 (2012). https://doi.org/10.1007/s11325-011-0536-7

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  • DOI: https://doi.org/10.1007/s11325-011-0536-7

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