Uric acid as a potential mediator of cardiovascular morbidity in obstructive sleep apnea syndrome |
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| Institution: | 1. Department of Pulmonary Medicine, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey;2. Department of Pulmonary Medicine, Gazi Osmanpasa University School of Medicine, Tokat, Turkey;3. Nephrology Clinic, Karaman State Hospital, Karaman, Turkey;4. Department of Medicine, Kayseri Training and Research Hospital, Kayseri, Turkey;5. Department of Neurology, Kayseri Training and Research Hospital, Kayseri, Turkey;6. Division of Rheumatology, Department of Medicine, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey;7. Division of Renal Diseases and Hypertension, University of CO, Denver, USA;8. Division of Nephrology, Department of Medicine, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey;1. Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, IRCCS Cà Granda Ospedale Maggiore Foundation, Milano, Italy;2. Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy;3. Department of Pharmacological Sciences and Biomolecular, University of Milan, Milan, Italy;4. IRCCS Multimedica, Milano, Italy;1. The Bruce and Ruth Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel;2. Heart Failure Unit, Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Lin Medical Center, Haifa, Israel;3. Heart Failure Clinic, Lin Medical Center, Haifa, Israel;4. Cardiovascular Department, Poriya Medical Center, Tiberius, Israel;1. Department of Respiratory Medicine, The Second Affiliated Hospital of Medical College, Xi''an Jiaotong University, Xi''an, Shaanxi Province, China;2. Department of Gastroenterology, Xi''an North Hospital, Xi''an, Shaanxi Province, China;3. Department of Respiratory Medicine, Traditional Chinese Medical Hospital of Shaanxi Province, Xi''an, Shaanxi Province, China |
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| Abstract: | Background and aimsObstructive sleep apnea (OSA) is now considered as an independent risk factor for cardiovascular (CV) disease. Although uric acid is increasingly being implicated in CV morbidity and mortality, no study attempted to determine independent role of uric acid in CV morbidity of OSA patients. We aimed to assess the role of serum uric acid as a potential mechanism of CV morbidity in a nonselected cohort of OSA patients.MethodsThis was a cohort study in which patients who had undergone a formal sleep study for diagnosis of OSA were recruited. Included patients were grouped according to apnea–hypopnea index (AHI) as mild, moderate and severe OSA. Patients with AHI < 5 served as control group. Patients were interrogated as to cardiovascular morbid conditions which included prior history and an established diagnosis of coronary artery disease, cerebrovascular accident, congestive heart failure due to coronary artery disease and arrhythmias.Results436 OSA patients included (72 controls, 97 with mild, 75 with moderate, and 192 with severe OSA). The severe group also had higher serum uric acid level compared with the control and other OSA groups. Linear regression showed that the Ln uric acid was positively associated with Ln AHI score. In unadjusted logistic regression, severe OSA was associated with higher odds of a cardiovascular event, OR = 2.81 (1.307–6.041), p = 0.0081 while the other categories of sleep apnea were not. However, severe OSA was no longer significant after adjusting for age, gender, diabetes mellitus status, hypertension status, BMI, and smoking, OR = 1.882 (0.826–4.287), p = 0.1322. Uric acid was significantly higher in those who had a cardiovascular event even in the mild, moderate and severe OSA groups.ConclusionHyperuricemia is strongly associated with cardiovascular disease in OSA patients. This strong relationship persists even after controlling for well-known traditional risk factors for cardiovascular disease. |
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