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Relationship between surfactant proteins B and C and obstructive sleep apnea: is serum SP-B concentration a potential biomarker of obstructive sleep apnea?

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Abstract

Background

Surfactant proteins B and C are mainly synthesized, secreted by alveolar type II cells, and affected by hypoxia and mechanical stretches. We hypothesized that their serum levels might be altered by intermittent hypoxia and swing of intrathoracic pressure of obstructive sleep apnea (OSA).

Methods

Consecutive 140 middle-aged males, suspicious of OSA determined by polysomnography, were studied. Surfactant proteins B and C were determined by ELISA.

Results

Surfactant protein B (41.39 ± 6.01 vs 44.73 ± 7.62 ng/L, p = 0.005), not C (32.60 ± 6.00 vs 32.43 ± 6.44 ng/L, p = 0.61), significantly lowered in moderate to severe OSA subjects than in non to mild OSA subjects. Severity of OSA is inversely correlated with serum surfactant protein B. Adjusting age, body mass index, and smoking history, compared to subjects with surfactant protein B (SP-B) ≥43.35 ng/L, those with SP-B <43.35 ng/L showed significantly increased 1.528-fold risk for moderate to severe OSA (p = 0.009), whereas no association between surfactant protein C and OSA was observed. Prevalence of moderate to severe OSA in lower SP-B group is higher than that in higher SP-B group (62.7 vs 38.4 %, p = 0.003). Serial and parallel tests on Epworth sleep scale (ESS) and SP-B evaluation can be complementary and prove helpful with high specificity (94.44 %) and sensitivity (84.48 %) to detect moderate to severe OSA.

Conclusions

Serum surfactant protein B, rather than C, is decreased in some individuals with moderate to severe OSA, compared to non to mild OSA subjects. Serum surfactant protein B might be a potential biomarker to diagnose OSA.

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Abbreviations

OSA:

Obstructive sleep apnea

ATII:

Alveolar type II cells

PSG:

Polysomnography

BMI:

Body mass index

HbA1C:

Hemoglobin A1C

FBG:

Fasting blood glucose

SPs:

Surfactant proteins

SP-B:

Surfactant protein B

SP-C:

Surfactant protein C

KL-6:

Krebs von den Lungen-6

AHI:

Apnea/hypopnea index

LSaO2 :

Lowest oxyhemoglobin saturation

ODI3 :

Oxygen desaturation index of 3 %

ODI4 :

Oxygen desaturation index of 4 %

BP:

Blood pressure

ESS:

Epworth sleep scale

PPV:

Positive predictive value

NPV:

Negative predictive value

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Acknowledgments

This study was supported by the National Natural Science Foundation of China (grant number: 81260017)

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Graduate School of Xinjiang Medical University, Urumqi, 830000, Xinjiang, China

    Liang Shao, Arikin Abdireim, Yongping Zhang & Xiangyang Zhang

  2. The Center of Hypertension of the People’s Hospital of Xinjiang Uygur Autonomous Region, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang, No. 91 Tianchi Road Tianshan District, Urumqi, 830001, Xinjiang, China

    Liang Shao, Nanfang Li, Xiaoguang Yao, Mulalibieke Heizati, Arikin Abdireim, Yingchun Wang, Zufeiya Abulikemu, Delian Zhang, Guijuan Chang, Ling Zhou, Jing Hong, Yongping Zhang & Jianqiong Kong

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  1. Liang Shao
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Correspondence to Nanfang Li.

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Shao, L., Li, N., Yao, X. et al. Relationship between surfactant proteins B and C and obstructive sleep apnea: is serum SP-B concentration a potential biomarker of obstructive sleep apnea?. Sleep Breath 20, 25–31 (2016). https://doi.org/10.1007/s11325-015-1179-x

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  • DOI: https://doi.org/10.1007/s11325-015-1179-x

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