Increased oxidative stress and reduced antioxidant enzyme activity in obstructive sleep apnea syndrome
Background: Obstructive sleep apnea (OSA) is associated with neurological complications. An increase in hypoxia due to OSA may cause generation of reactive oxygen species (ROS) via hypoxia-activated enzyme xanthine oxidase (XO) in the last reactions of the purine catabolism. Another enzyme playing a part in purine metabolism is adenosine deaminase (ADA) which is an important enzyme in the maturation and function of T lymphocytes. ROS produced by XO, can reduce antioxidant paraoxonase-1 (PON1). The objective of this study is to determine the activities of XO, ADA, and PON1 activities in OSA patients in comparison with those in non-apneic controls. Methods: The plasma activities of XO, ADA, and PON1 were determined in 57 patients with OSA (apnea-hypopnea index [AHI]) ≥ 15) of whom 19 had cardiovascular disease (CVD), and 38 had OSA but were without CVD and 27 non-apneic controls (AHI ≤ 5). A venous blood sample was obtained early in the morning after the polysomnography night. Results: XO and ADA activity was found to be significantly higher in the OSA group than the control group. PON1 activity was found lower in the OSA group, but this result was not statistically significant. Min O2 saturation had a significant independent relationship with ADA activity; and AHI had a significant independent relationship with PON1 activity after adjustment for confounding factors that are considered to be related to oxidative stress. Conclusions: These results support the existence of oxidative stress in OSA and OSA should be considered as a systemic disease.
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