title: Gut epithelial barrier markers in patients with obstructive sleep apnea.
abstract: Obstructive sleep apnea (OSA) is now being recognized as an additional contributing factor to the pathogenesis of obesity-related comorbidities. At the same time, there is now increasing evidence to suggest that intestinal wall permeability plays a role in the development of metabolic syndrome. In the present study, circulating zonulin and fatty acid binding protein (I-FABP) were measured in association with metabolic, hepatic, and inflammatory parameters.
  
  
  
  Compared with controls, plasma I-FABP levels were significantly higher in patients with OSA (571 pg/mL [IQR 290-950] vs 396 pg/mL [IQR 234-559], p = 0.04). Zonulin levels were similar between groups. Significant relationships were observed between zonulin levels and waist circumference (p < 0.05), glucose (p < 0.05), and insulin (p < 0.05). In addition, in the OSA group, zonulin levels correlated negatively with the mean nocturnal oxygenation saturation (p < 0.05) and positively with total cholesterol (p < 0.05), alanine aminotransferase (ALT) (p < 0.005), aminotransferase (AST) (p < 0.01), gamma glutamyltransferase (GGT) (p < 0.005), and high-sensitivity C-reactive protein (hs-CRP) (p < 0.05). Multivariate analysis showed that associations between zonulin and ALT, AST, and hs-CRP were attenuated, but not eliminated, after adjustment for other variables.
  
  
  
  The results of this study suggest that OSA is a risk factor for intestinal damage, regardless of metabolic profile, and that intestinal permeability might be a possible contributor to nonalcoholic fatty liver disease in patients with OSA.
authors.affiliation: Servei de Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Institut de investigacio (IdISPa), Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Antonia
authors.initials: A
authors.lastname: Barceló
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Esquinas
authors.affiliation: Servei de Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Robles
authors.affiliation: Institut de investigacio (IdISPa), Hospital Universitari Son Espases, Palma de Mallorca, Spain; Servei de Unitat de Investigació, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Piérola
authors.affiliation: Institut de investigacio (IdISPa), Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain; Servei de Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: De la Peña
authors.affiliation: Servei de Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Aguilar
authors.affiliation: Servei de Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain. Electronic address: dr.morell.uab@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Morell-Garcia
authors.affiliation: Institut de investigacio (IdISPa), Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain; Servei de Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Alonso
authors.affiliation: Servei de Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Toledo
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain; Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, IRBLleida, Lleida, Catalonia, 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; Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, IRBLleida, Lleida, Catalonia, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Barbé
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002772:Cholera Toxin / Q000097:blood*; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006242:Haptoglobins; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D007413:Intestinal Mucosa / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000150:complications; D009765:Obesity / Q000097:blood / Q000150:complications*; D011498:Protein Precursors; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; C493319:FABP1 protein, human; D050556:Fatty Acid-Binding Proteins; D006242:Haptoglobins; D011498:Protein Precursors; C408043:zonulin; D002772:Cholera Toxin; D000410:Alanine Transaminase
keywords: Fatty acid binding protein (I-FABP); Intestinal wall; Sleep apnea; Zonulin