OBJECTIVES: To determine whether surgical treatment of obstructive sleep apnea/hypopnea syndrome (OSAHS) has an impact on C-reactive protein (CRP) level.
STUDY DESIGN: Prospective study of 34 consecutive subjects undergoing surgical treatment for OSAHS. CRP levels were evaluated preoperatively and 2 months postoperatively. The most commonly performed procedure was uvulopalatopharyngoplasty (UPPP) combined with radiofrequency tongue base reduction.
RESULTS: Seven patients were treated for mild OSAHS and 23 were treated for moderated/severe OSAHS; 18 of 23 patients with moderate/severe disease had relative elevation of preoperative CRP levels. Mean CRP level decreased from 0.33 mg/dL preoperatively to 0.16 mg/dL postoperatively (P = 0.003). Even patients who did not achieve complete “cure" by classical polysomnography (PSG) criteria may benefit from lowered CRP levels. All patients, however did achieve reduction in apnea hypopnea index and improvement in clinical symptoms.
CONCLUSIONS: Levels of CRP were elevated preoperatively but decreased after surgical treatment. Therefore, OSAHS surgical treatment may be useful in reduction of CRP levels in patients who will not or cannot accept nasal-CPAP therapy.
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References
1.
NietoFLYoungTBLindBK. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health JAMA2000;283:1829–36.
2.
PeppardPEYoungTPaltaM. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med2000;342:1378–84.
3.
ShamsuzzamanASMWinnickiMLanfranchiP. Elevated C-reactive protein in patients with obstructive sleep apnea. Circulation2002;105:2462–4.
4.
YokoeTMinoguchiKMatsuoH. Elevated levels of C-reactive protein and Interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation2003;107:1129–34.
5.
FriedmanMIbrahimHJosephNJ. Staging of obstructive sleep apnea/hypopnea syndrome: a guide to appropriate treatment. Laryngoscope2000;114:454–9.
6.
PearsonTAMensahGAAlexanderWR. Markers of inflammation and cardiovascular disease: application to clinical and public health practice. A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation2003;107:499–511.
7.
SherASchechtmanKPiccirilloJ. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep1995;19:156–77.
8.
TracyRP. Inflammation in cardiovascular disease. Circulation1998;97:2000–2.
9.
PlutzkyJ. Inflammatory pathways in atherosclerosis and acute coronary syndromes. Am J Cardiol2001;88:10K–15K.
10.
RidkerPM. High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. Circulation2001;103:1813–8.
11.
HartmannGTschopMFisherR. High altitude increases circulating interleukin-6, interleukin-1 antagonist and C-reactive protein. Cytokine2000;12:246–52.
12.
VgontzasANPapanicolaouDABixterO. Circardian interleukin-6 secretion and quantity and depth of sleep. J Clin Endocrinol Metab1999;84:2603–7.
13.
WeaverEMTucker WoodsonBStewardDL. Polysomnography indexes are discordant with quality of life, symptoms, and reaction times in sleep apnea patients. Otolaryngol Head Neck Surg2005;132:255–62.
