title: Changes in ghrelin, leptin and pro-inflammatory cytokines after therapy in Obstructive Sleep Apnea Syndrome (OSAS) patients.
abstract: BACKGROUND
  The correlations between the levels of cytokines, apnea, and obesity are not well understood. The aim of this study was to investigate the relationship between sleep apnea, body mass index (BMI) and plasma levels of leptin, ghrelin, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α).
  
  
  METHODS
  Levels of leptin, ghrelin, IL-6, and TNF-α were compared in 20 obese (BMI > 30 kg/m²) and 6 non-obese patients (BMI < 27 kg/m²) with Obstructive Sleep Apnea Syndrome (OSAS), and in 13 obese and 11 non-obese control subjects without OSAS. All patients were investigated with Polysomnography (PSG) and ENT examination with flexible endoscopy and Müller's maneuver. Twelve patients were treated with continuous positive airway pressure (CPAP) and 14 with surgery. Fasting leptin, ghrelin and cytokine levels were measured at baseline, 2 days and 6 months after initiation of CPAP treatment, and 6 months after surgery.
  
  
  RESULTS
  Leptin, ghrelin and cytokine levels did not change significantly from baseline after 2 days of CPAP. After 6 months of CPAP or surgery, leptin, IL-6, and TNF-α levels were decreased in all OSAS patients. No difference in ghrelin levels was observed.
  
  
  CONCLUSIONS
  Elevated leptin levels are not determined by obesity alone, since they decreased with Apnea Hypopnea Index reduction. Higher pro-inflammatory cytokine basal levels observed in patients with OSAS were not correlated with BMI.
authors.affiliation: ENT Department, University of Siena, Italy.
authors.forename: Sante
authors.initials: S
authors.lastname: De Santis
authors.affiliation: ENT Department, University of Siena, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Cambi
authors.affiliation: ENDOCRINOLOGY Department, Presidio Ospedaliero.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Tatti
authors.affiliation: ENT Department, University of Siena, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Bellussi
authors.affiliation: ENT Department, University of Siena, Italy.
authors.forename: Desiderio
authors.initials: D
authors.lastname: Passali
mesh_terms: D000328:Adult; D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure; D016207:Cytokines / Q000097:blood; D005260:Female; D054439:Ghrelin / Q000097:blood; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000503:physiopathology*; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D016207:Cytokines; D054439:Ghrelin; D015850:Interleukin-6; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha