Background: Circulating nuclear factor-kappaB (NF-kappaB)-dependent genes, particularly tumor necrosis factor-alpha (TNF-alpha), are elevated in obstructive sleep apnea syndrome (OSAS) and likely contribute to cardiovascular disease. Furthermore, TNF-alpha is associated with excessive daytime sleepiness. We investigated the predictors of TNF-alpha and related genes in large, well-selected cohorts of subjects with OSAS and control subjects.

Methods: We performed a prospective study of 30 subjects who did not have OSAS (22 nonsleepy normal control subjects and 8 sleepy nonapneic subjects who snored), 36 subjects with mild to moderate OSAS, and 31 subjects with severe OSAS; all subjects were male. Groups were matched for age, body mass index, and other relevant variables. Subjects had no other disease and were not regularly taking medication. All had serum for TNF-alpha and related assays drawn after polysomnography. A total of 49 suitable subjects were treated with continuous positive airway pressure (CPAP); sleep studies together with serum assays were repeated 6 wk later.

Results: TNF-alpha levels were higher in subjects with OSAS than in subjects without OSAS (p < 0.001). In multivariate analysis, TNF-alpha was independently associated with the desaturation index (r = 0.399, p < 0.001), Epworth Sleepiness Score (r = 0.243, p = 0.005), and cholesterol (r = 0.216, p = 0.018). Furthermore, TNF-alpha levels were higher in sleepy nonapneic subjects who snored than in normal control subjects (p = 0.002) but lower than in subjects with OSAS (p = 0.03). CPAP therapy lowered TNF-alpha levels (p = 0.004). Another NF-kappaB-dependent cytokine, interleukin-8 (IL-8), showed similar differences between groups and after CPAP therapy, but a range of other mediators of inflammation, including IL-1, IL-6, IL-10, and IL-12, showed no differences.

Conclusion: Intermittent hypoxia is the strongest predictor of TNF-alpha levels, supporting a role for inflammation in the cardiovascular pathophysiology of OSAS. Furthermore, TNF-alpha levels are independently associated with excessive daytime sleepiness.

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乐备实是国内专注于提供高质量蛋白检测以及组学分析服务的实验服务专家，自2018年成立以来，乐备实不断寻求突破，公司的服务技术平台已扩展到单细胞测序、空间多组学、流式检测、超敏电化学发光、Luminex多因子检测、抗体芯片、PCR Array、ELISA、Elispot、PLA蛋白互作、多色免疫组化、DSP空间多组学等30多个，建立起了一套涵盖基因、蛋白、细胞以及组织水平实验的完整检测体系。

 
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