While it is not always clear what the association between SDB and a given health problem is, new research exposes that at least one factor may help to explain the increased risk of cardiovascular problems that affects even people with mild to moderate SDB.
Researcher Reena Mehra, M.D., M.S., assistant professor of medicine at the Case Western Reserve School of Medicine in Cleveland, Ohio, and colleagues set out to investigate the morning and evening levels of three pro-thrombotic markers, plasminogen activator inhibitor-1 (PAI-1), fibrinogen and D-dimer, relative to the severity of SDB as defined by the apnea/hypopnea index (AHI) in 537 subjects.
The study appears online ahead of the print edition of the American Journal of Respiratory and Critical Care Medicine on the American Thoracic Society's Web site.
After controlling for variables including body mass index (BMI), age, sex and co-morbidities, they found that for every 5-unit increase in AHI under 15, there was a corresponding significant increase of about 10 percent in PAI-1. Similarly, for every 5-unit increase in AHI under 15, fibrinogen significantly increased on average by about 8.4 mg/dL. There was no significant increase in D-dimer in relation to AHI, however.
"These data suggest that individuals with even modest levels of SDB (which describes a large proportion of the adult population) may have an enhanced pro-thrombotic biochemical profile, increasing their CVD risk," said Dr. Mehra.
Increased morning PAI-1 remained significantly associated with SDB severity in those with mild to moderate SDB even after taking into account evening PAI-1, suggesting that morning may be a reflection of overnight SDB-related physiologic stress, and indicating that PAI-1 may be a good biomarker for assessing SDB stress. These diurnal findings were not noted with fibrinogen.
Interestingly, there was no association between either PAI-1 or fibrinogen at AHI above 15, which is generally the clinical cut-off between moderate and more sever SDB. "These data suggest that even at levels of SDB considered to be mild, there is an enhanced thrombotic state. Further research is needed to identify whether treatment of milder degree of SDB results in improvements in markers of thrombosis, a known contributor to cardiovascular disease," said Dr. Mehra.
"In summary, these data suggest that, at low to modest levels of SDB, incremental increases in AHI are associated with increases in levels of two pro-thrombotic biomarkers associated with CVD. Future directions include exploring whether treatment of even mild to moderate levels of SDB improves biomarkers of thrombosis, and performing further work to understand the specific pathways and pathobiology of SDB-related increased risk of thrombosis."
John Heffner, M.D., past president of the American Thoracic Society, commented, "This study joins so many others that paint a consistent picture of sleep as a fundamentally important physiologic process for health that can negatively impact multiple organ systems when disordered breathing occurs. This study provides an important insight into how sleep disruptions can trigger prothrombotic processes that may eventually lead to cardiovascular diseases and perhaps other conditions like strokes. Other investigators will now pursue the interaction of SDB with prothrombic states."
This research was funded by the National Heart Lung Blood Institute.
Keely Savoie | EurekAlert!
How cancer metastasis happens: Researchers reveal a key mechanism
19.01.2018 | Weill Cornell Medicine
Researchers identify new way to unmask melanoma cells to the immune system
17.01.2018 | Duke University Medical Center
On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.
We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...
What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...
For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.
Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...
At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.
No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...
Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.
Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...
08.01.2018 | Event News
11.12.2017 | Event News
08.12.2017 | Event News
19.01.2018 | Materials Sciences
19.01.2018 | Health and Medicine
19.01.2018 | Physics and Astronomy