title: Impact of OSA on biological markers in morbid obesity and metabolic syndrome.
abstract: OBJECTIVE
  There is compelling evidence that obstructive sleep apnoea (OSA) can affect metabolic syndrome (MetS) and cardiovascular risk, but the intermediate mechanisms through which it occurs have not been well defined. We explored the impact of OSA in morbidly obese patients with MetS on adipokines, pro-inflammatory markers, endothelial dysfunction, and atherosclerosis markers.
  
  
  METHODS
  We included 52 morbidly obese patients in an observational study matched for age, gender and central obesity in 3 groups (OSA-MetS, Non-OSA-MetS, and Non OSA-non-MetS). Anthropometrical, blood pressure, and fasting blood measurements were obtained the morning after an overnight polysomnography. VEGF, soluble CD40 ligand (sCD40L), TNF-α, IL-6, leptin, adiponectin, and chemerin were determined in serum by ELISA. OSA was defined as apnea/ hypopnea index ≥ 15 and MetS by NCEP-ATP III.
  
  
  RESULTS
  Cases and control subjects did not differ in age, BMI, waist circumference, and gender (43 ± 10 years, 46 ± 5 kg/m(2), 128 ± 10 cm, 71% females). The cases had severe OSA with 47 (32-66) events/h, time spent < 90% SpO2 7% (5%-31%). All groups presented similar serum cytokines, adipokines, VEGF, and sCD40L levels.
  
  
  CONCLUSIONS
  In a morbidly obese population with established MetS, the presence of OSA did not determine any differences in the studied mediators when matched by central obesity. Morbidly obese NonOSA-NonMetS had a similar inflammatory, adipokine VEGF, and sCD40L profile as those with established MetS, with or without OSA. Obesity itself could overwhelm the effect of sleep apnea and MetS in the studied biomarkers.
  
  
  BACKGROUND
  Salord N; Gasa M; Mayos M; Fortuna-Gutierrez AM; Montserrat JM; Sánchez-de-la-Torre M; Barceló A; Barbé F; Vilarrasa N; Monasterio C. Impact of OSA on biological markers in morbid obesity and metabolic syndrome.
authors.affiliation: Sleep Unit, Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain ; Section of Respiratory Medicine, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Spain ; Universtitat Autonoma de Barcelona, Department of Medicine, Barcelona, Spain ; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Neus
authors.initials: N
authors.lastname: Salord
authors.affiliation: Sleep Unit, Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain ; Section of Respiratory Medicine, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Spain.
authors.forename: Mercè
authors.initials: M
authors.lastname: Gasa
authors.affiliation: Universtitat Autonoma de Barcelona, Department of Medicine, Barcelona, Spain ; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain ; Sleep Unit, Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Mayos
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain ; Sleep Unit, Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Fortuna-Gutierrez
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain ; Sleep Unit, Department of Respiratory Medicine, Hospital Clinic de Barcelona, Barcelona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Montserrat
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain ; Respiratory Diseases Research Unit, Hospital Universitari Arnau de Vilanova, IRB Lleida Lleida, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Sánchez-de-la-Torre
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain ; Clinic Analysis Service, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Antonia
authors.initials: A
authors.lastname: Barceló
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain ; Clinic Analysis Service, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Barbé
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain ; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Vilarrasa
authors.affiliation: Sleep Unit, Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain ; Section of Respiratory Medicine, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Spain ; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Monasterio
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D015415:Biomarkers / Q000097:blood; D023201:CD40 Ligand / Q000097:blood; D016022:Case-Control Studies; D018925:Chemokines / Q000097:blood; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications*; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications*; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D018925:Chemokines; D036341:Intercellular Signaling Peptides and Proteins; D015850:Interleukin-6; D020738:Leptin; C478630:RARRES2 protein, human; D014409:Tumor Necrosis Factor-alpha; D042461:Vascular Endothelial Growth Factor A; D023201:CD40 Ligand
keywords: Obstructive sleep apnoea; adipokines; endothelial dysfunction; inflammatory markers; metabolic syndrome; obesity