TOPIC: Sleep Disorders
      TYPE: Original Investigations
      PURPOSE: To assess possible relationships between Obstructive Sleep Apnea (OSA) syndrome and Gluthatione (GSH) redox system: Glutathione Peroxidase1 (GPx1) and Gluthatione Reductase (GSSG-Red). OSA syndrome is characterized by sleep fragmentation, repetitive episodes of hypoxia/reoxygenation, systemic and glymphatic activity lipid dysregulation, increasing oxidative stress with direct effect on cerebral neural cells.
      METHODS: We conducted a folow-up prospective study of 74 outpatients (mean aged 53.05±5.15 years) and 33 healthy controls (mean aged 51.69±5.19). Demographic, anthropometric (weight, height), smoking history, blood pressure, plasma lipid profile: Triglycerides (TG), Total Cholesterol (TC), Low Density Lipoprotein cholesterol (LDLc), High Density Lipoprotein cholesterol (HDLc), Very Low Density Lipoprotein cholesterol (VLDL), nonHigh Density Lipoprotein cholesterol (nonHDLc) usefull in evaluating Atherogenic Coefficient (AC) {(Non-HDLc)/HDLc}, and Atherogenic Index of Plasma (AIP) {(logTG)/HDLc}, blood albumin and glycemia were performed. GPx1 and GSSG-Red activities were measured by High Performance Liquid Chromatography (HPLC) with electrochemical detection. All subjects underwent cardiorespiratory poligraphy with VitalNight plus Sleep Diagnosis System according to the American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events, version 2.6 recommendations. Before testing, all participants were asked to complete the Epworth Sleepiness Scale (ESS) questionnaire. Statistical analysis included Spearman correlations tests, t test and one-way ANOVA test.
      RESULTS: In OSA syndrome patients versus control, we found GPx1 (p=0.0002), blood albumin (p=0.0001), AC (p=0.05) were significantly lower, while glycemia (p=0.03), TG (p=0.04), TG/albumin ratio (p=0.0001), LDL/HDLc ratio (p=0.02), VLDL/albumin ratio (p=0.0001) were higher. In OSA syndrome group, correlations are as follows: GPx1 and HDLc (r=-0.23;p=0.04), LDLc/albumin ratio (r=-0.33;p=0.003), VLDL/albumin (r=-0.25;p=0.03), TG (r=-0.25;p=0.02), ESS Index (r=0.24;p=0.04); GSSG-Red and ODI (r=-0.24;p=0.03), the % of sleep time spent with SpO2<90% (minutes) (TST90SpO2) (r=-0.25;p=0.02), Apneas Index (AI) (r=-0.31;p=0.006), snoring (r=0.29;p=0.01), glycemia (r=0.27;p=0.01), TG/HDLc ratio (r=-0.24;p=0.03); Apnea/Hypopnea Index (AHI) and TG (r=0.23;p=0.04), VLDL (r=0.23;p=0.04).
      CONCLUSIONS: OSA syndrome may be related to elevated oxidative stress burden through GPx1 and GSSG-Red enymes pathway. GPx1 could have prognostic value and, should consider screening for cardiovascular diseases in patients with OSA syndrome.
      CLINICAL IMPLICATIONS: A better understanding of pathophysiological mechanisms of GSH system dysregulation in OSA syndrome may improve the role of treatment with continous positive airway pressure (CPAP) for clearing the brain from the neurotoxic products that accumulate during wakefulness.
      DISCLOSURES: no disclosure on file for Roxana Maria Nemes;
      No relevant relationships by Ancuta Petrovan, source=Web Response
      no disclosure on file for Carmen Monica Pop;
      No relevant relationships by Ligia Puiu, source=Web Response
      no disclosure on file for Emilia Tabacu;