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Soluble P-selectin levels in patients with obstructive sleep apnea: a systematic review and meta-analysis

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Abstract

Purpose

Obstructive sleep apnea (OSA) patients are at increased risk for cardiovascular disease, stroke, atherosclerosis, hypertension, and venous thromboembolism. Elevated soluble P-selectin (sP-selectin) levels are also associated with increased risk of above diseases. But whether sP-selectin levels in OSA patients are higher than their counterparts remain unclear, since previous studies yielded inconsistent results. Therefore, a meta-analysis is warranted.

Methods

PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible studies. Studies were included if they reported sP-selectin levels of both OSA patients and non-OSA controls. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated to determine the effect sizes.

Results

Nine eligible studies were finally evaluated. When all the studies were pooled, sP-selectin levels in OSA patients were significantly higher than that in controls (SMD = 0.54, 95% CI 0.29–0.78, I2 = 66%, p < 0.0001). In the subgroup analysis based on BMI matched groups, sP-selectin levels were significantly higher in OSA patients than that in controls (SMD = 0.52, 95% CI 0.27–0.76, I2 = 23%, p < 0.0001). In the subgroup analysis stratified by blood source, either serum sP-selectin levels or plasma sP-selectin levels in OSA patients were higher than that in controls. Moderate-to-severe OSA patients had significant higher sP-selectin levels (SMD = 0.80, 95% CI 0.45–1.15, I2 = 67%, p < 0.00001), while mild OSA patients showed no significant difference with controls.

Conclusion

The pooled results reveal that OSA patients have higher sP-selectin levels than non-OSA controls. This conclusion remains unaltered in all subgroups other than the subgroup of mild OSA patients. Additional studies are warranted to better identify the role of sP-selectin as a potential biomarker in OSA patients.

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Authors and Affiliations

  1. Department of Internal Medicine, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, 310022, China

    Ding Zhu & Yaqing Li

  2. Respiratory Group, Department of Endoscopy, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, 310022, China

    Ding Zhu & Yaqing Li

  3. Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310000, China

    Ding Zhu & Yaqing Li

  4. Department of Respiratory Medicine, Xixi Hospital of Hangzhou, Hangzhou, 310023, China

    Zhibo Xu

  5. Department of Respiratory Medicine, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, China

    Tingting Liu

  6. 1 Banshan East Road, Hangzhou, China

    Yaqing Li

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Conceptualization: DZ; literature search: ZX; formal analysis: DZ and ZX; writing—original draft preparation: DZ; writing—review and editing: YL; supervision: TL

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Correspondence to Yaqing Li.

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Zhu, D., Xu, Z., Liu, T. et al. Soluble P-selectin levels in patients with obstructive sleep apnea: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 278, 4633–4644 (2021). https://doi.org/10.1007/s00405-021-06831-4

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