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Biomarkers of Alzheimer’s disease in severe obstructive sleep apnea–hypopnea syndrome in the Chinese population

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A Letter to the Editor to this article was published on 02 July 2021

Abstract

Purpose

Patients with severe obstructive sleep apnea–hypopnea syndrome are often accompanied by symptoms such as decreased cognitive function and daytime sleepiness, while cognitive function is often associated with biomarkers of Alzheimer’s disease. Therefore, this study aims to explore the level of Alzheimer’s disease biomarkers in the plasma of obstructive sleep apnea–hypopnea syndrome patients as well as the relationship between cognitive function and daytime sleepiness.

Methods

Between May and July 2019, 35 patients requiring hospitalization for severe obstructive sleep apnea–hypopnea syndrome and 16 normal control patients were selected from West China Hospital. Alzheimer’s disease biomarkers (Aβ40, Aβ42, t-tau, p-tau) in plasma were detected by ELISA in all 51 subjects. The differences in Alzheimer’s disease biomarkers between the two groups were compared. In addition, a correlation analysis of disease-related indicators and univariate analysis of the risk factors of obstructive sleep apnea–hypopnea syndrome was conducted using the logistic regression model.

Results

The plasma levels of Alzheimer’s disease biomarkers (Aβ40, t-tau, p-tau) in patients with severe obstructive sleep apnea–hypopnea syndrome were significantly higher than those in the control group (29.24 ± 32.52, 13.18 ± 10.78, p = 0.049; 11.88 ± 7.05, 7.64 ± 4.17, p = 0.037; 26.31 ± 14.41, 17.34 ± 9.12, p = 0.027). Aβ42, Aβ40, t-tau, and p-tau were significantly negatively correlated with mean oxygen saturation, low oxygen saturation and Mini-Mental State examination scale scores, and positively correlated with oxygen desaturation index and Epworth Sleepiness Scale scores. T-tau and p-tau can be used as new risk factors for obstructive sleep apnea–hypopnea syndrome.

Conclusion

Alzheimer’s disease biomarkers in the plasma of obstructive sleep apnea–hypopnea syndrome patients are higher than those in the control group, and the mechanism of action may be related to sleep disorders and night hypoxia. The Alzheimer’s disease biomarkers deposited in plasma may also cause the decline of patients’ cognitive function, increased daytime sleepiness and accelerate the progression of obstructive sleep apnea–hypopnea syndrome.

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Acknowledgements

We thank Daohong Meng, Professor of Public Health and Epidemiology in University of South Florida, for his suggestion on the study and discussion of the results. We also thank Maria Xu, for her contribution on the data analysis.

Funding

This project was supported by the National Basic Research and Development Program of China named Sleep Brain Function and Mechanism Research; Project No.: 2015CB856400.

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People’s Republic of China

    Weili Kong, Yun Zheng, Hailing Gu & Junhao Wu

  2. Department of Biostatistics, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5G2M9, Canada

    Wei Xu

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Contributions

WK: design of the research, collection of data, writing up of article; HG and JW: collection of experiment data; YZ and WX: analysis of experiment data, revising the article. All authors read and approved the final manuscript.

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Correspondence to Yun Zheng or Wei Xu.

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The authors declare that they have no conflict of interest.

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All participants gave their informed consent including for the use of ELISA data. The West China Hospital Ethics Review Committees approved the study protocols. Approval number is 2019(485).

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This article is part of the Topical Collection on sleep apnea syndrome. Guest editors: Manuele Casale, Rinaldi Vittorio.

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Kong, W., Zheng, Y., Xu, W. et al. Biomarkers of Alzheimer’s disease in severe obstructive sleep apnea–hypopnea syndrome in the Chinese population. Eur Arch Otorhinolaryngol 278, 865–872 (2021). https://doi.org/10.1007/s00405-020-05948-2

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