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Use of blood biomarkers to screen for obstructive sleep apnea
PURPOSE: Obstructive sleep apnea (OSA) is a highly prevalent disorder associated with increased risk for cardiovascular disease, diabetes, and other chronic conditions. Unfortunately, up to 90% of individuals with OSA remain without a diagnosis or therapy. We assess the relationship between OSA and...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove Medical Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005302/ https://www.ncbi.nlm.nih.gov/pubmed/29942168 http://dx.doi.org/10.2147/NSS.S164488 |
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author | Fleming, Wesley Elon Holty, Jon-Erik C Bogan, Richard K Hwang, Dennis Ferouz-Colborn, Aliya S Budhiraja, Rohit Redline, Susan Mensah-Osman, Edith Osman, Nadir Ishag Li, Qing Azad, Armaghan Podolak, Susann Samoszuk, Michael K Cruz, Amabelle B Bai, Yang Lu, Jiuliu Riley, John S Southwick, Paula C |
author_facet | Fleming, Wesley Elon Holty, Jon-Erik C Bogan, Richard K Hwang, Dennis Ferouz-Colborn, Aliya S Budhiraja, Rohit Redline, Susan Mensah-Osman, Edith Osman, Nadir Ishag Li, Qing Azad, Armaghan Podolak, Susann Samoszuk, Michael K Cruz, Amabelle B Bai, Yang Lu, Jiuliu Riley, John S Southwick, Paula C |
author_sort | Fleming, Wesley Elon |
collection | PubMed |
description | PURPOSE: Obstructive sleep apnea (OSA) is a highly prevalent disorder associated with increased risk for cardiovascular disease, diabetes, and other chronic conditions. Unfortunately, up to 90% of individuals with OSA remain without a diagnosis or therapy. We assess the relationship between OSA and blood biomarkers, and test the hypothesis that combinations of markers provide a characteristic OSA signature with diagnostic screening value. This validation study was conducted in an independent cohort in order to replicate findings from a prior feasibility study. PATIENTS AND METHODS: This multicenter prospective study consecutively enrolled adult male subjects with clinically suspected OSA. All subjects underwent overnight sleep studies. An asymptomatic control group was also obtained. Five biomarkers were tested: glycated hemoglobin (HbA1c), C-reactive protein (CRP), uric acid, erythropoietin (EPO), and interleukin-6 (IL-6). RESULTS: The study enrolled 264 subjects. The combination of HbA1c+CRP+EPO (area under the curve 0.78) was superior to the Epworth Sleepiness Scale (ESS; 0.53) and STOP-Bang (0.70) questionnaires. In non-obese subjects, the combination of biomarkers (0.75) was superior to body mass index (BMI; 0.61). Sensitivity and specificity results, respectively, were: HbA1c+CRP+EPO (81% and 60%), ESS (78% and 19%), STOP-Bang (75% and 52%), BMI (81% and 56%), and BMI in non-obese patients (81% and 38%). CONCLUSION: We verify our hypothesis and replicate our prior feasibility findings that OSA is associated with a characteristic signature cluster of biomarker changes in men. Concurrent elevations of HbA1c, CRP, and EPO levels should generate a high suspicion of OSA and may have utility as an OSA screening tool. Biomarker combinations correlate with OSA severity and, therefore, may assist sleep centers in identifying and triaging higher risk patients for sleep study diagnosis and treatment. |
format | Online Article Text |
id | pubmed-6005302 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-60053022018-06-25 Use of blood biomarkers to screen for obstructive sleep apnea Fleming, Wesley Elon Holty, Jon-Erik C Bogan, Richard K Hwang, Dennis Ferouz-Colborn, Aliya S Budhiraja, Rohit Redline, Susan Mensah-Osman, Edith Osman, Nadir Ishag Li, Qing Azad, Armaghan Podolak, Susann Samoszuk, Michael K Cruz, Amabelle B Bai, Yang Lu, Jiuliu Riley, John S Southwick, Paula C Nat Sci Sleep Original Research PURPOSE: Obstructive sleep apnea (OSA) is a highly prevalent disorder associated with increased risk for cardiovascular disease, diabetes, and other chronic conditions. Unfortunately, up to 90% of individuals with OSA remain without a diagnosis or therapy. We assess the relationship between OSA and blood biomarkers, and test the hypothesis that combinations of markers provide a characteristic OSA signature with diagnostic screening value. This validation study was conducted in an independent cohort in order to replicate findings from a prior feasibility study. PATIENTS AND METHODS: This multicenter prospective study consecutively enrolled adult male subjects with clinically suspected OSA. All subjects underwent overnight sleep studies. An asymptomatic control group was also obtained. Five biomarkers were tested: glycated hemoglobin (HbA1c), C-reactive protein (CRP), uric acid, erythropoietin (EPO), and interleukin-6 (IL-6). RESULTS: The study enrolled 264 subjects. The combination of HbA1c+CRP+EPO (area under the curve 0.78) was superior to the Epworth Sleepiness Scale (ESS; 0.53) and STOP-Bang (0.70) questionnaires. In non-obese subjects, the combination of biomarkers (0.75) was superior to body mass index (BMI; 0.61). Sensitivity and specificity results, respectively, were: HbA1c+CRP+EPO (81% and 60%), ESS (78% and 19%), STOP-Bang (75% and 52%), BMI (81% and 56%), and BMI in non-obese patients (81% and 38%). CONCLUSION: We verify our hypothesis and replicate our prior feasibility findings that OSA is associated with a characteristic signature cluster of biomarker changes in men. Concurrent elevations of HbA1c, CRP, and EPO levels should generate a high suspicion of OSA and may have utility as an OSA screening tool. Biomarker combinations correlate with OSA severity and, therefore, may assist sleep centers in identifying and triaging higher risk patients for sleep study diagnosis and treatment. Dove Medical Press 2018-06-14 /pmc/articles/PMC6005302/ /pubmed/29942168 http://dx.doi.org/10.2147/NSS.S164488 Text en © 2018 Fleming et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Fleming, Wesley Elon Holty, Jon-Erik C Bogan, Richard K Hwang, Dennis Ferouz-Colborn, Aliya S Budhiraja, Rohit Redline, Susan Mensah-Osman, Edith Osman, Nadir Ishag Li, Qing Azad, Armaghan Podolak, Susann Samoszuk, Michael K Cruz, Amabelle B Bai, Yang Lu, Jiuliu Riley, John S Southwick, Paula C Use of blood biomarkers to screen for obstructive sleep apnea |
title | Use of blood biomarkers to screen for obstructive sleep apnea |
title_full | Use of blood biomarkers to screen for obstructive sleep apnea |
title_fullStr | Use of blood biomarkers to screen for obstructive sleep apnea |
title_full_unstemmed | Use of blood biomarkers to screen for obstructive sleep apnea |
title_short | Use of blood biomarkers to screen for obstructive sleep apnea |
title_sort | use of blood biomarkers to screen for obstructive sleep apnea |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005302/ https://www.ncbi.nlm.nih.gov/pubmed/29942168 http://dx.doi.org/10.2147/NSS.S164488 |
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