Plasma levels of neuropeptides and metabolic hormones, and sleepiness in obstructive sleep apnea

Background: Obstructive sleep apnea (OSA) is related to obesity and metabolic disorders. The main clinical symptoms are excessive daytime sleepiness (EDS) and snoring. However, not all patients with OSA manifest EDS. Hypocretin-1, neuropeptide Y, leptin, ghrelin and adiponectin are implicated in bot...

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Detalhes bibliográficos
Autores: Sánchez de la Torre, Manuel, Barceló Bennasar, Antonia, Piérola Lopetegui, Javier, Esquinas López, Cristina, de la Peña Bravo, Mónica, Durán Cantolla, Joaquín, Capote Gil, Francisco, Masa Jiménez, Juan Fernando, Marín Trigo, José María, Vilá Justribó, Manel, Cao, G, Martínez Alonso, Montserrat, de Lecea, Luis, Gozal, David, Montserrat Canal, Josep María, Barbé Illa, Ferran
Tipo de documento: artigo
Data de publicação:2011
País:España
Recursos:Universidad de Castilla-La Mancha
Repositório:RUIdeRA. Repositorio Institucional de la UCLM
OAI Identifier:oai:ruidera.uclm.es:10578/41104
Acesso em linha:https://hdl.handle.net/10578/41104
Access Level:Acceso aberto
Palavra-chave:EDS
Metabolism
OSA
Sleep apnea
Descrição
Resumo:Background: Obstructive sleep apnea (OSA) is related to obesity and metabolic disorders. The main clinical symptoms are excessive daytime sleepiness (EDS) and snoring. However, not all patients with OSA manifest EDS. Hypocretin-1, neuropeptide Y, leptin, ghrelin and adiponectin are implicated in both metabolic and sleep regulation, two conditions affected by OSA. We hypothesized that levels of these peptides may be related to EDS in OSA patients.Methods: We included 132 patients with EDS, as defined by an Epworth Sleepiness Scale (ESS) score = 13 (mean ± SD, 15.7 ± 2.3) and 132 patients without EDS as defined by an ESS score = 9 (6.5 ± 1.9). All patients had an apnea-hypopnea index (AHI) = 20 h(-1). Both groups were matched for gender (males; 83.3% vs. 85.6%), age (50.15 ± 11.2 yrs vs. 50.7 ± 9.9 yrs), body mass index (BMI) (31.8 ± 5.6 kg m(-2) vs. 32.1 ± 4.8 kg m(-2)), and apnea-hypopnea index (AHI) (45.5 ± 19.1 h(-1) vs. 43 ± 19.2 h(-1)).Results: OSA patients with EDS showed significantly higher plasma hypocretin-1 levels (p < 0.001) and lower plasma ghrelin levels (p < 0.001) than OSA patients without EDS. There were no statistically significant differences in neuropeptide Y (p = 0.08), leptin (p = 0.07) and adiponectin (p = 0.72) between the two groups. In the multiple linear regression model ESS score was associated with plasma levels of hypocretin-1, ghrelin and total sleep time.Conclusion: Our study shows that EDS in patients with OSA is associated with increased circulating hypocretin-1 and decreased circulating ghrelin levels, two peptides involved in the regulation of body weight, energy balance, sympathetic tone and sleep-wake cycle. This relationship is independent of AHI and obesity (two key phenotypic features of OSA).

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