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Shah, Aditi

University of British Columbia

Background: The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) has been termed the overlap syndrome (OVS) [1]. Patients with OVS have significantly higher overall and cardiovascular mortality than patients with COPD alone [2]. However, there is limited data are available on its pathophysiological. Systemic inflammation is a well-known key player in cardiovascular disease (CVD) pathogenesis. Both OSA and COPD are associated with increased systemic inflammation, suggesting that the inflammation may play a key role in causing the excess CV risks with OVS. Thesis Objectives: 1. Review existing evidence about systemic inflammatory and oxidative stress biomarkers in individuals with COPD alone, OSA alone and Overlap Syndrome (Chapter 1) 2. Evaluate Biomarkers in patients with suspected OSA and Obstructive Lung Disease: Associations between polysomnographic, demographic and spirometric parameters (Chapter 2) 3. Evaluate Circulating C-reactive protein levels in patients with suspected obstructive sleep apnea (Chapter 3) Methods: We examine systemic inflammatory and oxidative biomarker profile associated chronic obstructive airway disease (COPD), obstructive sleep apnea (OSA) and with overlap syndrome (COPD-OSA). We examined two registries to examine the biomarker profiles. The profile of inflammatory and oxidative stress biomarkers that play a role in cardiovascular disease risk were examined. This included C-reactive protein (CRP), IL-10, IL-6, PDGF-88, endostatin, e-selectin, thrombospondin-2, ICAM-1, VCAM-1. Results: In SACRR cohort, we identified variables such as body mass index, female sex and spirometry variables (FEV1) were associated with inflammatory biomarkers (IL-6, VCAM-1) Hypoxemia in REM sleep was associated with higher levels of oxidative stress marker (8-OHdG). In WASHS cohort, age, body mass index, female sex, neck circumference, and markers of hypoxemia severity (nadir SpO2%, mean SpO2%) and obstructive sleep apnea severity (Apnea-Hypopnea index (AHI)) was associated with higher levels of inflammatory biomarkers (CRP). In both the cohorts, there were no significant differences in inflammatory or oxidative biomarkers between patients who have OSA alone, COPD alone and overlap syndrome. Conclusion: Indices of hypoxemia, OSA severity (AHI) and patient characteristics are predictors of inflammatory and oxidative stress biomarkers. However, there was no significant difference in biomarker values in OVS patients in comparison to OSA and COPD alone.

Text

2024-04-30

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/88130

Experimental Medicine

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/