title: Elevated serum C-reactive protein and markers of sleep disordered breathing.
abstract: Background. Previous studies indicated sleep-disordered breathing (SDB) is associated with cardiovascular disease (CVD). Systemic inflammation is recognized as a risk factor for CVD. Studies examining SDB and inflammation are limited. Methods. We studied sleep duration, snoring, snorting, and daytime sleepiness, and an additive SDB score. The main outcome was a C-reactive protein (CRP) of >1 mg/dL. Results. Snoring, snorting, daytime sleepiness, and sleeping >7 or <7 hours, and the additive score were significantly associated with high CRP. The additive score was not associated in men but moderately associated in women in a multivariable model adjusting for age, gender, race/ethnicity, education, smoking, hypertension, alcohol intake, physical activity, body mass index, depression, diabetes, hypertension, and total cholesterol (P-interaction  = 0.42). For race/ethnicity, the association was strongest in Mexican Americans/others, modest in Non-Hispanic whites, and absent in Non-Hispanic blacks (P-interaction  = 0.07). Conclusions. The association between SDB and high CRP was present mainly in women and Mexican Americans, implying SDB has a residual, independent association with inflammation after controlling for lifestyle and metabolic risk factors like BMI, physical activity, depression, diabetes, and cholesterol.
authors.affiliation: Department of Dental Practice and Rural Health, West Virginia University, P.O. Box 9448, Health Sciences North, Morgantown, WV 26506, USA.
authors.forename: R Constance
authors.initials: RC
authors.lastname: Wiener
authors.forename: Rouxin
authors.initials: R
authors.lastname: Zhang
authors.forename: Anoop
authors.initials: A
authors.lastname: Shankar