A PROSPECTIVE OBSERVATIONAL STUDY OF POTENTIAL CORRELATION BETWEEN INFLAMMATORY BIOMARKERS CRP, IL-6, TNF–ALPHA AND SEVERITY OF OBSTRUCTIVE SLEEP APNEA

Abstract

Background: OSA is defined by the presence of repetitive episodes of upper airway obstruction during sleep. OSAS promotes persistent low intensity inflammatory state. Obsructive sleep apnea is classified as mild, moderate, severe according to apnea hypopnea index. 5-14 AHI is mild, 15-30 AHI is moderate, more than 30 is severe. Correlation between AHI severity index and inflammatory biomarkers like CRP, IL-6, TNF-α is assessed. Methods: This is a 18 months prospective study of 50 patients done in Coimbatore medical college. Patients with symptoms of OSA is screened with STOP BANG score and subjected to overnight polysomnogram and AHI is obtained. Blood samples collected and sent for biomarkers CRP, IL-6, TNF-α from patients with AHI ≥ 5. Results: Severity of OSA based on AHI was, Mild in 5 patients, Moderate in 17 patients, Severe in 28 patients. CRP was high in 2 patients which belongs severe category, IL-6 was high in 21 patients in which 7 belongs to moderate and 14 to severe category, TNF-α was high in 9 patients in which 3 belongs to moderate and 6 to severe category. Conclusion: There is evidence that moderate and severe AHI is associated with increased inflammatory cytokines particularly IL-6, TNF-α.These patients prone to develop complications like metabolic syndrome, cardiovascular events, CVA. Studies shown that cytokines significantly reduced with CPAP therapy. Due to limitations in our setup, patients non affordability, CPAP therapy and thereby reduction in cytokines levels could not be assessed.