title: Serum levels of vascular endothelial growth factor are elevated in patients with obstructive sleep apnea and severe nighttime hypoxia.
abstract: Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality; however, some patients with OSA do not develop cardiovascular disease even in the presence of severe nocturnal oxygen desaturations. Vascular endothelial growth factor (VEGF) is a hypoxia-sensitive glycoprotein stimulating neoangiogenesis. We hypothesized that VEGF production is increased in OSA because of repetitive nocturnal hypoxia. Three different groups were investigated: 10 OSA patients with severe nighttime hypoxia (Group A), 10 OSA patients with moderate hypoxia (Group B), and 10 healthy volunteers (Group C). Serum levels of VEGF were measured by ELISA from peripheral venous blood samples obtained at 7 AM. Group A had significantly (p < 0.01) increased VEGF serum levels when compared with Group B and Group C (mean +/- SEM: 410 +/- 77 pg/ml versus 224 +/- 38 pg/ml and 245 +/- 61 pg/ml). The degree of nocturnal oxygen desaturation in OSA significantly correlated with the VEGF concentrations (r = 0.67, p < 0.01). In conclusion, serum levels of VEGF are elevated in severely hypoxic patients with OSA and are related to the degree of nocturnal oxygen desaturation. This might constitute an adaptive mechanism to counterbalance the emergence of OSA-related cardiovascular disease.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Justus-Liebig-University, Giessen, Germany. Richard.Schulz@innere.med.uni-giessen.de
authors.forename: Richard
authors.initials: R
authors.lastname: Schulz
authors.forename: Christoph
authors.initials: C
authors.lastname: Hummel
authors.forename: Sabine
authors.initials: S
authors.lastname: Heinemann
authors.forename: Werner
authors.initials: W
authors.lastname: Seeger
authors.forename: Friedrich
authors.initials: F
authors.lastname: Grimminger
mesh_terms: D000222:Adaptation, Physiological; D000704:Analysis of Variance; D016022:Case-Control Studies; D004268:DNA-Binding Proteins / Q000502:physiology; D016228:Endothelial Growth Factors / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D004921:Erythropoietin / Q000502:physiology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D000860:Hypoxia / Q000097:blood* / Q000145:classification / Q000209:etiology; D051793:Hypoxia-Inducible Factor 1; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D016015:Logistic Models; D008222:Lymphokines / Q000097:blood*; D008297:Male; D009687:Nuclear Proteins / Q000502:physiology; D009765:Obesity / Q000150:complications; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D012008:Recurrence; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000145:classification / Q000209:etiology; D014157:Transcription Factors; D015854:Up-Regulation; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D014797:Vital Capacity
chemical_list: D004268:DNA-Binding Proteins; D016228:Endothelial Growth Factors; C497442:HIF1A protein, human; D051793:Hypoxia-Inducible Factor 1; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D008222:Lymphokines; D009687:Nuclear Proteins; D014157:Transcription Factors; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D004921:Erythropoietin; D010100:Oxygen