Journal of Alzheimers Disease & Parkinsonism
Open Access

Abstract

Obstructive sleep apnea syndrome (OSA) is defined as a combination of symptoms as a result of intermittent, recurrent constraint and/or complete airway overhead/ airway overflow (sleep disturbance). In the case of reduced airflow through upper respiratory tract >90%, in the presence of thoracic and/or abdominal movements over a period >10 sec., it is about obstructive apnea. With a ≥30% reduced airflow over the upper respiratory tract over a period of 10 seconds, desaturation ≥3% followed by waking or desaturation >4%. During desaturation episodes, the organism is subjected to chronic stress. This leads to reduced nitric oxide secretion, increased release of interleukin-6, tumor necrosis factor-alpha and other pro-inflammatory cytokines. The described pathological cascades are associated with the development of insulin resistance, arterial hypertension, metabolic syndrome, systemic atherosclerosis and increased cardiovascular risk. Thirty five (35) patients with OSA were included; age 42.9±8.8. The established results were compared to sex and age matched healthy control and with patients with no atherosclerotic changes. Routine blood analyses as CBC, serum iron, ferritin, hsCRP and specific hepcidin, homocysteine and vitamin B12 were measured in the included groups. IMT and FMT were used for atherosclerotic changes evaluation. We found increased serum hepcidin levels in OSA patients with IMT and FMD changes (99.1±14.7 μg/L) compared to healthy controls (19.5±2.1 µg/L); P<0.001. A positive correlation was found in OSA patients with atherosclerotic changes between IMT and FMD to serum hepcidin levels (r=0.809, r=0.877, resp.; P<0.01). Serum hepcidin correlates positively to homocysteine in OSA patients with atherosclerotic evidence changes (r=0.899, P<0.005). Brain-vascular disease risk factors are connected to obstructive sleep apnea syndrome. Dysregulation of iron homeostasis is one of the main risk atherogenesis factors. Early hepcidin quantification might predict an atherosclerosis occurrence in OSA patients, which might be very important for better clinical diagnosis and practice

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