Investigation of the relationship between inflammation and osas (obstructive sleep apnea syndrome)

Introduction and Aim: OSAS (Obstructive Sleep Apnea Syndrome), is a syndrome that is characterised by recurrent events of complete (apnea) or partial (hipopne) upper respiratory tract obstruction episodes during sleep and is frequently accompanied by reduced in O2 saturation. Many different types of sleep disorders are identified so far. Obstructive Sleep Apnea Syndrome is the most important one because of its prevelance, which is an average of 1-5 As a result of apnea and hypopneas, hypercarbia and hypoxemia occur and resulting in pathologies affecting various organs and systems such as intratohoracic pressure fluctuations, baroreceptor dysfunction, oxidative stress and endothelial dysfunction. Although the role of locally increased inflammation in the URT (Upper Respratuar Tract) in the pathogenesis of obstructive sleep apnea syndrome is recognised, it is predicted that hypoxia, asphyxia, hypercapnia and respiratory acidosis, which occur with different levels of decline in regular breathing that should continue spontaneously, causes to local and systemic inflamation. PSG (polisomnography) is used as a golden standart method in diagnosing obstructive sleep apnea syndrome. Radiologically, lateral head and neck graph can be used, CT and MRI can be used in a limited way. However, any biochemical marker that could be used in the diagnosis and follow-up has not been identified yet. In this study that will be conducted, we aimed to evaluate the role of inflammatory markers in OSAS, whether they are important in the diagnosis of disease is important, and whether there are similarities or discrepancies between OSAS patients and healthy volunteers. Materials and Methods: A total of 165 patients in the adult age group who underwent diagnostic PSG for the first time between December 2016 and July 2017 were evaluated at Düzce University Medical Faculty Hospital, sleep laboratories. Patients in this group who were not diagnosed with OSAS during evaluation according to PSG criteria in the sleep laboratory were used as the control group (AHI 5-15 Mild, AHI 15-30 Moderate, AHI> 30 severe OSAS). Patients were divided into 3 groups: AHI <5 (normal) Group 1, AHI 5-15 (mild) and AHI 15-30 (middle) Group 2, and AHI> 30 (severe) Group 3. A total of 165 patients who completed the study [Group 1 (n = 56), Group 2 (n = 69), Group 3 (n = 40)] were included in the iv statistical evaluation. Serum levels of IL-6, TNF-α, Neopterin and YKL-40 were measured in all patients and control group Results: There was a significant difference between groups in terms of IL-6, neopterin, and YKL-40 values. However, there was no significant difference in serum TNF-α levels among the groups. The median IL-6 measured in the severe group was significantly higher than in the normal and mild-to-moderate groups. The neopterin median value measured in the severe group was significantly higher than the values measured in the normal and mild-to-moderate groups. The mean value of YKL-40 measured in the severe group was significantly higher than the value measured in the normal group (p <0,05). Conclusion: OSAS is a systemic disease that affects many organs and systems, impairs quality of life, and reduces the daily performance and increases morbidity and mortality. In this study, we found inflammatory markers of IL-6, YKL-40 and neopterin were elevated in OSAS patients (especially severe group). Keywords: Obstructive Sleep Apne Syndrome, Neopterin, YKL- 40, IL-6, TNF-a, Inflammation.