Relationships Between a Range of Inflammatory Biomarkers and Subjective Sleep Quality in Chronic Insomnia Patients: A Clinical Study

Abstract

Lan Xia,1,* Ping Zhang,2,* Jing-Wen Niu,2 Wei Ge,2 Jun-Tao Chen,2 Shuai Yang,2 Ai-Xi Su,2 Yi-Zhou Feng,2 Fang Wang,3 Gong Chen,4 Gui-Hai Chen2 1Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China; 2Department of Neurology (Sleep Disorders), The Affiliated Chaohu Hospital of Anhui Medical University, Hefei (Chaohu), People’s Republic of China; 3Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China; 4Hefei Technology College, Hefei (Chaohu), People’s Republic of China*These authors contributed equally to this workCorrespondence: Gui-Hai ChenDepartment of Neurology (Sleep Disorders), The Affiliated Chaohu Hospital of Anhui Medical University, Hefei (Chaohu), People’s Republic of ChinaTel/Fax [phone]Email [email protected] ChenHefei Technology College, Hefei (Chaohu), People’s Republic of ChinaTel [phone]Fax [phone]Email [email protected]: To examine whether associations exist between chronic insomnia disorder (CID) and overlooked inflammatory factors (Serum amyloid protein A [SAA]), tumor necrosis factor [TNF]-α, granulocyte-macrophage colony-stimulating factor [GM-CSF], and regulated on activation and normal T cell expressed and presumably secreted [RANTES]).Patients and Methods: A total of 65 CID patients and 39 sex- and age-matched good sleeper (GS) controls participated in this study. They completed a baseline survey to collect data on demographics, and were elevated sleep and mood by Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), 17-item Hamilton Depression Rating Scale (HAMD-17) and 14-item Hamilton Anxiety Rating Scale (HAMA-14), respectively. The blood samples were collected and tested the serum levels of SAA, TNF-α, GM-CSF and RANTES.Results: The CID group had higher serum levels of SAA, TNF-α, and GM-CSF and a lower level of RANTES than the GS group. In the Spearman correlation analysis, SAA and GM-CSF positively correlated with the PSQI and AIS scores. After controlling for sex, HAMD-17 score, and HAMA-14 score, the partial correlation analysis showed that GM-CSF was positively correlated with PSQI score. Further stepwise linear regression analyses showed that GM-CSF was positively associated with the PSQI and AIS scores, while RANTES was negatively associated with them, and SAA was positively associated with just the AIS score.Conclusion: The serum levels of inflammatory mediators (SAA, TNF-α, and GM-CSF) were significantly elevated and the level of RANTES was significantly decreased in CID patients and, to some extent, the changes are related to the severity of insomnia. These findings may help us to improve interventions to prevent the biological consequences of CID by inhibiting inflammation, thereby promoting health.Keywords: chronic insomnia disorder, serum amyloid protein A; tumor necrosis factor (TNF)-α, granulocyte-macrophage colony-stimulating factor, regulated on activation and normal T cell expressed and presumably secreted

Keywords

• chronic insomnia disorder
• serum amyloid-a
• tumor necrosis factor (tnf)-α
• granulocyte-macrophage colony-stimulating factor
• regulated on activation and normal t cell expressed and presumably secreted