title: Vascular inflammation and sleep disordered breathing in a community-based cohort.
abstract: OBJECTIVE
  Sleep disordered breathing is associated with cardiovascular disease. The pathophysiologic mechanisms remain unclear, but enhanced vascular inflammation is implicated. We sought to evaluate the association of sleep disordered breathing with biomarkers of inflammation.
  
  
  METHODS
  Cross-sectional, observational.
  
  
  METHODS
  Community-based.
  
  
  METHODS
  There were 900 participants from the Framingham Heart Study site of the Sleep Heart Health Study (52% females, mean age 60 y, 23% ethnic minorities).
  
  
  METHODS
  None.
  
  
  METHODS
  We assessed circulating levels of nine inflammatory biomarkers in relation to polysomnographically-derived apnea-hypopnea index and hypoxemia index (% sleep time with oxyhemoglobin saturation < 90%). Multivariable models were adjusted for demographics, smoking, cardiovascular diseases, diabetes, and other potential confounders, without and with adjustment for body mass index.
  
  
  RESULTS
  With multivariable adjustment not including body mass index, the apnea-hypopnea index was associated with C-reactive protein, inter-leukin-6, fibrinogen, intercellular adhesion molecule-1, and P-selectin levels and hypoxemia index was associated with C-reactive protein, interleukin-6, and fibrinogen levels. After adjustment for body mass index, only the association of interleukin-6 with sleep disordered breathing remained significant: the adjusted mean serum interleukin-6 level was 2.93, 3.14, 3.34, and 4.62 pg/mL, respectively, in participants with apnea-hypopnea index < 5, 5-14.9, 15-29.9, and ≥ 30 events/h (P = 0.01 for trend) and 2.97, 3.01, 3.35, and 4.85 pg/mL, respectively, in participants with hypoxemia index < 0.5, 0.5-4.9, 5-9.9, and ≥ 10% of sleep time (P = 0.02 for trend).
  
  
  CONCLUSIONS
  In a community-based sample, sleep disordered breathing is associated with higher levels of interleukin-6, a marker of myocardial infarction risk and mortality. Adiposity may mediate the increased levels of C-reactive protein, fibrinogen, intercellular adhesion molecule-1, and P-selectin observed in sleep disordered breathing.
authors: Department of Medicine, American University of Beirut, Beirut, Lebanon. hchami@aub.edu.lb
authors: Hassan A
authors: HA
authors: Chami
authors: João D
authors: JD
authors: Fontes
authors: Ramachandran S
authors: RS
authors: Vasan
authors: John F
authors: JF
authors: Keaney
authors: George T
authors: GT
authors: O'Connor
authors: Martin G
authors: MG
authors: Larson
authors: Emelia J
authors: EJ
authors: Benjamin
authors: Daniel J
authors: DJ
authors: Gottlieb
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000097:blood* / Q000150:complications*
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D019007:P-Selectin; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein
keywords: Epidemiology; inflammation; sleep apnea syndromes
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