title: Impact of Obstructive Sleep Apnea Syndrome on Endothelial Function, Arterial Stiffening, and Serum Inflammatory Markers: An Updated Meta-analysis and Metaregression of 18 Studies.
abstract: BACKGROUND
  Obstructive sleep apnea syndrome (OSAS) has been indicated to contribute to the development of cardiovascular disease; however, the underlying mechanism remains unclear. This study aimed to test the hypothesis that OSAS may be associated with cardiovascular disease by elevating serum levels of inflammatory markers and causing arterial stiffening and endothelial dysfunction.
  
  
  RESULTS
  Related scientific reports published from January 1, 2006, to June 30, 2015, were searched in the following electronic literature databases: PubMed, Excerpta Medica Database, ISI Web of Science, Directory of Open Access Journals, and the Cochrane Library. The association of OSAS with serum levels of inflammatory markers, endothelial dysfunction, and arterial stiffening were investigated. Overall, 18 eligible articles containing 736 patients with OSAS and 424 healthy persons were included in this meta-analysis. Flow-mediated dilation in patients with moderate-severe OSAS was significantly lower than that in controls (standardized mean difference -1.02, 95% CI -1.31 to -0.73, P<0.0001). Carotid-femoral pulse wave velocity (standardized mean difference 0.45, 95% CI 0.21-0.69, P<0.0001), augmentation index (standardized mean difference 0.57, 95% CI 0.25-0.90, P<0.0001), and serum levels of high-sensitivity C-reactive protein and C-reactive protein (standardized mean difference 0.58, 95% CI 0.42-0.73, P<0.0001) were significantly higher in patients with OSAS than in controls.
  
  
  CONCLUSIONS
  OSAS, particularly moderate-severe OSAS, appeared to reduce endothelial function, increase arterial stiffness, and cause chronic inflammation, leading to the development of cardiovascular disease.
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China (J.W., W.Y., M.G., F.Z., C.G., Y.Y.).
authors.forename: Jiayang
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China (J.W., W.Y., M.G., F.Z., C.G., Y.Y.).
authors.forename: Wenyuan
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China (J.W., W.Y., M.G., F.Z., C.G., Y.Y.).
authors.forename: Mingxin
authors.initials: M
authors.lastname: Gao
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China (J.W., W.Y., M.G., F.Z., C.G., Y.Y.).
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China (J.W., W.Y., M.G., F.Z., C.G., Y.Y.).
authors.forename: Chengxiong
authors.initials: C
authors.lastname: Gu
authors.affiliation: Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China (J.W., W.Y., M.G., F.Z., C.G., Y.Y.).
authors.forename: Yang
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Otolaryngology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China (Y.W.).
authors.forename: Yongxiang
authors.initials: Y
authors.lastname: Wei
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D015854:Up-Regulation; D059289:Vascular Stiffness; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D002097:C-Reactive Protein
keywords: C‐reactive protein; arterial stiffening; endothelial dysfunction; obstructive sleep apnea