title: The impact of obstructive sleep apnea and nasal CPAP on circulating adiponectin levels.
abstract: OBJECTIVE
  Although obstructive sleep apnea syndrome (OSAS) is known to be an important risk factor for cardiovascular diseases, the mechanism behind this association has not been fully elucidated. Transendothelial migration of monocytes mediated by adhesion molecules is a crucial step in the pathogenesis of atherosclerosis. We investigated the effect of hypoxic stress on plasma adiponectin and tumor necrosis factor-α (TNF-α) levels and whether adiponectin and TNF-α modulate adhesion molecules in patients with OSAS.
  
  
  METHODS
  In 22 patients, plasma adiponectin and TNF-α levels and serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1) were determined early in the morning after polysomnography and after nasal continuous positive airway pressure (nCPAP) treatment.
  
  
  RESULTS
  Plasma adiponectin levels were inversely correlated with the apnea-hypopnea index (AHI) (r = -0.582, p < 0.005) and % time in SpO2 <90 % (r = -0.539, p < 0.01) but not with the body mass index (BMI). TNF-α levels were positively correlated with the AHI (r = 0.462, p < 0.05) and BMI (r = 0.452, p < 0.05). Serum sICAM-1 levels were inversely correlated with plasma adiponectin levels (r = -0.476, p < 0.05) but not with TNF-α levels. Although plasma TNF-α levels decreased after overnight nCPAP treatment (p < 0.05), plasma adiponectin levels increased after long-term nCPAP (3 months) treatment (p < 0.02) in ten patients.
  
  
  CONCLUSIONS
  Our findings suggest that reduced adiponectin and elevated TNF-α levels in plasma are associated with OSAS-induced hypoxic stress. Decreased adiponectin levels are associated with sICAM-1 levels.
authors.affiliation: Second Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan, noriy@naramed-u.ac.jp.
authors.forename: Masanori
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: Motoo
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Fujita
authors.forename: Noriko
authors.initials: N
authors.lastname: Koyama
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Fukuoka
authors.forename: Shinji
authors.initials: S
authors.lastname: Tamaki
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Tomoda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kimura
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D045422:Continuous Positive Airway Pressure; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; C573420:ICAM1 protein, human; D014409:Tumor Necrosis Factor-alpha; D018799:Intercellular Adhesion Molecule-1