Effects of nasal continuous positive airway pressure on soluble cell adhesion molecules in patients with obstructive sleep apnea syndrome.
OBJECTIVE
Obstructive sleep apnea syndrome is common in middle-aged men and may be associated with an increased risk of cardiovascular disease. We investigated the effect of nasal continuous positive airway pressure (CPAP) treatment on levels of soluble cell adhesion molecules-which have been shown to be associated with the development of atherosclerosis-in these patients.


METHODS
We studied 23 patients with obstructive sleep apnea syndrome diagnosed by polysomnography who were treated with nasal CPAP. Serum soluble intercellular adhesion molecule-1, E-selectin, and vascular cell adhesion molecule-1 levels were measured before nasal CPAP was started, and after 3 or 4 days (n = 19), 1 month (n = 23), or 6 months (n = 11) of treatment.


RESULTS
After 3 to 4 days of nasal CPAP therapy, the mean (+/- SD) soluble E-selectin level had decreased from 89 +/- 44 ng/mL to 69 +/- 28 ng/mL (P = 0.002). After 1 month, the soluble intercellular adhesion molecule-1 level had decreased from 311 +/- 116 ng/mL to 249 +/- 74 ng/mL (P = 0.02). After 6 months, soluble vascular cell adhesion molecule-1 levels had not changed significantly, while the mean soluble intercellular adhesion molecule-1 level (212 +/- 59 ng/mL) had decreased further (P = 0.02). Before treatment, soluble intercellular adhesion molecule-1 levels and the apnea and hypopnea index were correlated (r = 0.43, P = 0.04).


CONCLUSIONS
Obstructive sleep apnea and hypopnea have a significant adverse effect on serum soluble cell adhesion molecule-1 levels that may be reduced by nasal CPAP treatment.
Chin
K
K
Department of Physical Therapeutics, Kyoto University Hospital of Medicine, Kyoto, Japan.
Nakamura
T
T
Shimizu
K
K
Mishima
M
M
Nakamura
T
T
Miyasaka
M
M
Ohi
M
M
D000328:Adult; D001835:Body Weight; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology; D015815:Cell Adhesion Molecules / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D019040:E-Selectin / Q000097:blood; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009666:Nose; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000379:methods; D012306:Risk; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000628:therapy*; D012894:Sleep Stages; D013997:Time Factors; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D015815:Cell Adhesion Molecules; D019040:E-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002784:Cholesterol