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Gamma glutamyl transferase and oxidative stress in obstructive sleep apnea: a study in 1744 patients

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Abstract

Objective

We analyze a large population of patients to determine whether gamma glutamyl transferase (GGT) levels are increased in sleep apnea-hypopnea syndrome (OSA) and whether these levels are related to clinical characteristics or polygraphic indexes.

Methods

A cross-sectional study in a population of 1744 patients referred for OSA suspicion was conducted. The following variables were determined: glucose, cholesterol, triglycerides, aspartate aminotransferase (GOT), alanine aminotransferase (GPT), GGT, body mass index, waist-hip ratio (WHR), and overnight sleep study.

Results

The 483 patients with GGT ≥40 IU/l were younger and more obese, and had a pattern of more centrally distributed fat than the 1261 with GGT <40 IU/l. Patients with high levels of GGT also consumed more alcohol, had a poorer biochemical profile, and had more respiratory and oximetric alterations during sleep. GGT levels were significantly correlated with AHI, DI, and CT90. In the binary regression test, WHR, glucose, cholesterol, triglycerides, and grams of alcohol consumed per day predicted GGT levels ≥40 IU/l, while none of the polygraphic variables had predictive value.

Conclusions

High GGT levels were associated with the severity of OSA. However, this relationship seems to be due to the coexistence of other associated factors, mainly central obesity, rather than to the respiratory disorders found in this disease.

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References

  1. Lee DH, Gross M, Jacobs DR (2004) Association of serum carotenoids and tocopherols with gamma-glutamyltransferase: the Cardiovascular Risk Development in Young Adults (CARDIA) Study. Clin Chem 50:582–588

    Article  CAS  PubMed  Google Scholar 

  2. Lee DH, Jacobs DR Jr, Gross M et al (2003) Gamma-glutamyltransferase is a predictor of incident diabetes and hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Clin Chem 49:1358–1366

    Article  CAS  PubMed  Google Scholar 

  3. Lee DS, Evans JC, Robins SJ et al (2007) Gamma glutamyl transferase and metabolic syndrome, cardiovascular disease, and mortality risk: the Framingham Heart Study. Arterioscler Thromb Vasc Biol 27:127–133

    Article  CAS  PubMed  Google Scholar 

  4. Gozal D, Kheirandish-Gozal L (2008) Cardiovascular morbidity in obstructive sleep apnea. Oxidative stress, inflammation, and much more. Am J Respir Crit Care Med 177:369–375

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Lavie L (2003) Obstructive sleep apnoea syndrome: an oxidative stress disorder. Sleep Med Rev 7:35–51

    Article  PubMed  Google Scholar 

  6. Schulz R, Mahmoudi S, Hattar K et al (2000) Enhanced release of superoxide from polymorphonuclear neutrophils in obstructive sleep apnea. Impact of continuous positive airway pressure therapy. Am J Respir Crit Care Med 162:566–570

    Article  CAS  PubMed  Google Scholar 

  7. Lee SD, Ju G, Choi JA, Kim JW, Yoon IY (2012) The association of oxidative stress with central obesity in obstructive sleep apnea. Sleep Breath 16:511–517

    Article  PubMed  Google Scholar 

  8. Mancuso M, Bonanni E, LoGerfo A et al (2012) Oxidative stress biomarkers in patients with untreated obstructive sleep apnea syndrome. Sleep Med 13:632–636

    Article  PubMed  Google Scholar 

  9. Devulapally K, Pongonis R, Khayat R (2009) OSA: the new cardiovascular disease: part II: overview of cardiovascular diseases associated with obstructive sleep apnea. Heart Fail Rev 14:155–164

    Article  PubMed Central  PubMed  Google Scholar 

  10. Barceló A, Barbé F, de la Peña M et al (2006) Antioxidant status in patients with sleep apnoea and impact of continuous positive airway pressure treatment. Eur Respir J 27:756–760

    Article  PubMed  Google Scholar 

  11. Kanbay A, Kaya E, Buyukoglan H et al (2011) Serum gamma-glutamyl transferase activity is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome. Respir Med 105:637–642

    Article  PubMed  Google Scholar 

  12. Alberti KG, Eckel RH, Grundy SM et al (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645

    Article  CAS  PubMed  Google Scholar 

  13. Iber C, Ancoli-Israel S, Chesson A, Quan SF, for the American Academy of Sleep Medicine (2007) The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, 1st edn. American Academy of Sleep Medicine, Westchester

    Google Scholar 

  14. Ruttmann E, Brant LJ, Concin H, Health Monitoring and Promotion Program Study Group et al (2005) Gamma-glutamyltransferase as a risk factor for cardiovascular disease mortality: an epidemiological investigation in a cohort of 163,944 Austrian adults. Circulation 112:2130–2137

    Article  CAS  PubMed  Google Scholar 

  15. Meisinger C, Döring A, Schneider A, Löwel H, KORA Study Group (2006) Serum gammaglutamyltransferase is a predictor of incident coronary events in apparently healthy men from the general population. Atherosclerosis 189:297–302

    Article  CAS  PubMed  Google Scholar 

  16. Stojakovic T, Scharnagl H, Trauner M et al (2010) Serum gammaglutamyl transferase and mortality in persons undergoing coronary angiography—The Ludwigshafen Risk and Cardiovascular Health Study. Atherosclerosis 208(2):564–571

    Article  CAS  PubMed  Google Scholar 

  17. Barcelo A, Miralles C, Barbe F, Vila M, Pons S, Agusti AG (2000) Abnormal lipid peroxidation in patients with sleep apnea. Eur Respir J 16:644–647

    Article  CAS  PubMed  Google Scholar 

  18. Song SH, Kwak IS, Kim YJ et al (2007) Can γ-glutamyltransferase be an additional marker of arterial stiffness? Circ J 71:1715–1720

    Article  CAS  PubMed  Google Scholar 

  19. García-Díaz E, Quintana-Gallego E, Ruiz A, Carmona-Bernal C, Sánchez-Armengol A, Botebol-Benhamou G, Capote F (2007) Respiratory polygraphy with actigraphy in the diagnosis of sleep apnea-hypopnea syndrome. Chest 131:725–732

    Article  PubMed  Google Scholar 

  20. Kawamoto R, Kohara K, Tabara Y, Miki T, Otsuka N (2009) Serum gamma-glutamyl transferase levels are associated with metabolic syndrome in community-dwelling individuals. J Atheroscler Thromb 16(4):355–362

    Article  CAS  PubMed  Google Scholar 

  21. Punjabi NM, Caffo BS, Goodwin JL et al (2009) Sleep-disordered breathing and mortality: a prospective cohort study. PLoS Med 6(8):e1000132

    Article  PubMed Central  PubMed  Google Scholar 

  22. Christou K, Kostikas K, Pastaka C, Tanou K, Antoniadou I, Gourgoulianis KI (2009) Nasal continuous positive airway pressure treatment reduces systemic oxidative stress in patients with severe obstructive sleep apnea syndrome. Sleep Med 10(1):87–94

    Article  PubMed  Google Scholar 

  23. Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365:1046–1053

    Article  PubMed  Google Scholar 

  24. Young T, Finn L, Peppard PE et al (2008) Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 31:1071–1078

    PubMed Central  PubMed  Google Scholar 

  25. Rodríguez-Rodríguez E, Perea JM, López-Sobaler AM, Ortega RM (2009) Obesity, insulin resistance and increase in adipokines levels: importance of the diet and the physical activity. Nutr Hosp 24:415–421

    PubMed  Google Scholar 

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Conflict of interest

None of the authors have any conflict of interest with the subject matter or materials discussed in the manuscript here reported.

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Authors and Affiliations

  1. Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocío University Hospital, Sevilla, Spain

    A. Sánchez-Armengol, C. Caballero-Eraso, C. Carmona-Bernal, M. Asensio-Cruz & F. Capote

  2. Torrecárdenas Hospital, Almería, Spain

    P. Villalobos-López

  3. Biomedical Research Institute, Sevilla, Spain

    A. Sánchez-Armengol, C. Caballero-Eraso, C. Carmona-Bernal & F. Capote

  4. Respiratory Department, Arnau de Vilanova Hospital, Lleida, Spain

    F. Barbé

  5. CIBERes (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias), Lleida, Spain

    F. Barbé

  6. Calle Aguilas n 16 casa1, Sevilla, 41003, Spain

    C. Caballero-Eraso

Authors
  1. A. Sánchez-Armengol
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  2. P. Villalobos-López
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  3. C. Caballero-Eraso
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  4. C. Carmona-Bernal
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  5. M. Asensio-Cruz
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  6. F. Barbé
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  7. F. Capote
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Corresponding author

Correspondence to C. Caballero-Eraso.

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Sánchez-Armengol, A., Villalobos-López, P., Caballero-Eraso, C. et al. Gamma glutamyl transferase and oxidative stress in obstructive sleep apnea: a study in 1744 patients. Sleep Breath 19, 883–890 (2015). https://doi.org/10.1007/s11325-014-1115-5

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  • DOI: https://doi.org/10.1007/s11325-014-1115-5

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