Oxidative and carbonyl stress in pregnant women with obstructive sleep apnea
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Pregnant women are particularly susceptible to sleep-disordered breathing. Obstructive sleep apnea (OSA) in pregnancy is associated with poor pregnancy and fetal outcomes. Oxidative stress caused by intermittent hypoxemia and reoxygenation may impact pregnancy health. We hypothesize that pregnant women with OSA have a pronounced oxidative stress profile.
A case-control study was performed to study oxidative stress markers in the serum of pregnant women with or without OSA. Patients with OSA were identified between 2003 and 2009. Contemporaneous controls were pregnant subjects without apnea, gasping, or snoring around the time of delivery. Serum markers of oxidative and carbonyl stress were measured by spectrophotometric/fluorometric methods. Multiple linear regression analysis was used with a model including age, body mass index at delivery, history of diabetes, and gestational age.
Serum samples from 23 OSA cases and 41 controls were identified. Advanced oxidation protein products, a marker for oxidative stress, and advanced glycation end products (AGEs), a marker for carbonyl stress, were significantly lower in women with OSA than in controls (p value <0.0001). Total antioxidant capacity was higher in women with OSA in comparison to controls (p value <0.0001). The difference in AGEs remained significant even after adjusting for confounders.
Contrary to our hypothesis, the results of this study suggest that pregnant women with OSA have higher antioxidant capacity and lower oxidative and carbonyl stress markers compared to controls, suggesting a possible protective effect of intermittent hypoxia. Whether OSA in pregnancy impacts oxidative stress differently than OSA in the general population remains to be confirmed.
KeywordsOxidative stress Carbonyl stress Obstructive sleep apnea Sleep-disordered breathing Pregnancy
Compliance with ethical standards
Conflict of interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants, participation in speakers’ bureaus, membership, employment, consultancies, stock ownership or other equity interest, and expert testimony or patent-licensing arrangements) or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript. GB received research equipment support from Respironics for a federally funded study; however, Respironics had no role in the current study.
Human and animal rights and informed consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants prospectively recruited into the study. Waiver of consent was obtained for the retrospective component of the study. Both were IRB approved.
GB received funding from NIH R01HL130702 and R01HD078515 and Perkins Charitable Foundation. The Perkins Foundation had no role in study design, conduct, interpretation, or submission of the manuscript.
- 30.Ozkan Y, Firat H, Simsek B, Torun M, Yardim-Akaydin S (2008) Circulating nitric oxide (NO), asymmetric dimethylarginine (ADMA), homocysteine, and oxidative status in obstructive sleep apnea-hypopnea syndrome (OSAHS). Sleep Breath 12(2):149–154. doi: 10.1007/s11325-007-0148-4 CrossRefPubMedGoogle Scholar
- 34.Karacay O, Sepici-Dincel A, Karcaaltincaba D, Sahin D, Yalvac S, Akyol M et al (2010) A quantitative evaluation of total antioxidant status and oxidative stress markers in preeclampsia and gestational diabetic patients in 24-36 weeks of gestation. Diabetes Res Clin Pract 89(3):231–238. doi: 10.1016/j.diabres.2010.04.015 CrossRefPubMedGoogle Scholar
- 35.de Ranitz-Greven WL, Bos DC, Poucki WK, Visser GH, Beulens JW, Biesma DH et al (2012) Advanced glycation end products, measured as skin autofluorescence, at diagnosis in gestational diabetes mellitus compared with normal pregnancy. Diabetes Technol Ther 14(1):43–49. doi: 10.1089/dia.2011.0105 CrossRefPubMedGoogle Scholar
- 36.de Ranitz-Greven WL, Kaasenbrood L, Poucki WK, Hamerling J, Bos DC, Visser GH et al (2012) Advanced glycation end products, measured as skin autofluorescence, during normal pregnancy and pregnancy complicated by diabetes mellitus. Diabetes Technol Ther 14(12):1134–1139. doi: 10.1089/dia.2012.0120 CrossRefPubMedGoogle Scholar
- 37.Pertynska-Marczewska M, Glowacka E, Sobczak M, Cypryk K, Wilczynski J (2009) Glycation endproducts, soluble receptor for advanced glycation endproducts and cytokines in diabetic and non-diabetic pregnancies. Am J Reprod Immunol 61(2):175–182. doi: 10.1111/j.1600-0897.2008.00679.x CrossRefPubMedGoogle Scholar
- 41.Garcia-Benavides L, Guzman-Sanchez A, Hernandez-Mora FJ, Muro-Gomez AM, Gomez-Martinez ML, Siller-Lopez FR (2012) PP078. Total antioxidant capacity in patients with pregnancy induced hypertension: its relation to maternal and/or perinatal complications. Pregnancy Hypertens. 2(3):282–283. doi: 10.1016/j.preghy.2012.04.189 CrossRefPubMedGoogle Scholar
- 46.Lam JC, Tan KC, Lai AY, Lam DC, Ip MS (2012) Increased serum levels of advanced glycation end-products is associated with severity of sleep disordered breathing but not insulin sensitivity in non-diabetic men with obstructive sleep apnoea. Sleep Med 13(1):15–20. doi: 10.1016/j.sleep.2011.07.015 CrossRefPubMedGoogle Scholar
- 50.Duthie GG, Morrice PC, Ventresca PG, McLay JS Effects of storage, iron and time of day on indices of lipid peroxidation in plasma from healthy volunteers. Clin Chim Acta n206(3):207–213Google Scholar