Türk Uyku Tıbbı Dergisi (Jun 2015)

Is Hepcidin a Good Marker for Inflammation in Obstructive Sleep Apnea Syndrome (OSAS) Patients?

  • Hikmet Firat,
  • Cengiz Özdemir,
  • Esra Bilgin,
  • Faith S. Luyster,
  • Melike Yüceege,
  • Murat Kizilgün,
  • Ahmet U. Demir,
  • Patrick J. Strollo,
  • Sadik Ardiç

DOI
https://doi.org/10.4274/jtsm.02.009
Journal volume & issue
Vol. 2, no. 2
pp. 33 – 37

Abstract

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Objective Obstructive Sleep Apnea syndrome (OSAS) is a clinical syndrome characterized by recurrent episodes of upper airway obstruction during sleep, resulting in chronic intermittent hypoxia and causing inflammation. IL-6 and CRP are the most commonly studied inflammation biomarkers in OSAS. Given that IL-6 is an important activator of hepcidin during inflammation. In this study, hepcidin levels in OSAS patients were examined. Materials and Methods A total of 44 patients undergoing Polysomnography (PSG) for suspected sleep disorder breathing were studied. Patients were classified as having no to mild OSAS (n=15) or moderate to severe OSAS (n=29) based on apnea-hypopnea index (AHI) (AHI <15 vs. AHI ≥15, respectively). Blood samples were obtained at night before PSG and in morning to obtain hepcidin levels. Results Patients with moderate to severe OSAS had lower evening hepcidin levels (U=-3.91, p<.001) and a greater change in evening to morning hepcidin levels (t=-2.83, p=.007) than patients with no or mild sleep apnea. AHI was negatively correlated with evening hepcidin (Hep E) (rs=-0.48, p =0.001) but was not significantly associated with morning hepcidin (Hep M) or change in evening to morning hepcidin levels. Greater Hep E levels were associated with significantly decreased odds of having moderate to severe sleep apnea even after controlling for covariates. A greater change in Hep E to Hep M levels were associated with a 1.08-fold increase in the odds of having moderate to severe sleep apnea (95% CI 1.02-1.15, p=.02). Conclusion This is a pioneer study to date to investigate the association between hepcidin and OSAS. Among patients with moderate-severe OSAS, significant increases in Hep E levels and change in Hep E to Hep M levels were found. Hepcidin may be a useful marker for the detection of hypoxia/reoxygenation episodes and inflammation in OSAS.

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