Selected routine laboratory tests in the clinical assessment of patients with obstructive sleep apnea.

INTRODUCTION: Obstructive sleep apnea (OSA) is a chronic disease characterized by repetitive complete or partial occlusion of the upper airways during sleep with respiratory muscle effort, which leads to consecutive apneas and hypopneas. Obstruction of the upper airways during sleep leads to repetitive episodes of disrupted airflow and consequent changes in blood oxygenation, resulting in hypoxaemia and hypercapnia. Intermittent hypoxaemia induces the production of pro-inflammatory factors and promotes metabolic dysregulation and platelet aggregation. OBJECTIVE: The main aim of this study was to determine differences, if any, in selected standard parameters in routine laboratory tests often used in GP practice between patients with obstructive sleep apnea, without comorbidities, and a well-defined control group with the absence of this syndrome proven in polygraphic examination. MATERIAL AND METHODS: Of the 192 clinically assessed persons with suspected OSA and admitted to the Internal Medicine Department in Lublin, 85 were qualified for the study after application of exclusion criteria. Demographic and health behaviour-related data, medical history regarding sleep habits and cardiovascular disease, were collected from each patient. RESULTS: Apart from significantly higher MCV and MCH among the cpontrol group, no significant differences were found between patients with obstructive sleep apnea and the control group. CONCLUSIONS: The results can be useful for the holistic assessment of the health status of patients with newly-diagnosed OSA.

Local elasticity of the aorta in patients with type 2 diabetes mellitus.

OBJECTIVE: Arterial elasticity is important for assessing the state of an artery. This cross-sectional study aimed to non-invasively examine stiffness parameters of the ascending aorta in patients with type 2 diabetes mellitus (T2DM). METHODS: We studied 58 patients, including 38 with T2DM and 20 controls. The stiffness of the aorta was evaluated during transthoracic echocardiography. Aortic parameters of stiffness, such as the stiffness index, elasticity index, and compliance index, were calculated using the aortic maximal diameter, aortic minimal diameter, and blood pressure. RESULTS: Pulse pressure values were significantly higher patients with T2DM than in controls. The ß index was significantly higher in patients with T2DM lasting for >7 years compared with those with T2DM lasting for <7 years. Mean aortic compliance was significantly lower in patients with a longer duration of diabetes than in those with a shorter duration of diabetes. Aortic elasticity was significantly lower in patients with diabetes and arterial hypertension compared with patients without diabetes with concomitant arterial hypertension. CONCLUSIONS: Patients with T2DM, especially when T2DM is long-term, have increased stiffness and decreased compliance of the ascending aorta. Pulse pressure, which is a cardiovascular risk factor, is also significantly increased in patients with T2DM.

Obstructive sleep apnea may increase the risk of Alzheimer's disease.

OBJECTIVES: Amyloid-ß 1-40 (Aß 1-40) and amyloid-ß 1-42 (Aß 1-42) are the proteins known to be involved in the pathogenesis of Alzheimer's disease (AD)-the most common cause of dementia in the elderly. Hypoxia is suspected to be one of conditions associated with Aß plasma level increase. A common reason of hypoxia is obstructive sleep apnea (OSA), characterized by recurrent episodes of apnea. AIM: The aim of the study was to evaluate plasma Aß 1-40 and Aß 1-42 concentrations in patients with OSA. METHODS: Patients with suspected OSA (n = 112) underwent polygraphic examinations Patients with confirmed OSA (n = 81) showed apnea/hypopnea index greater than or equal to 5. Mild and moderate form of the disease was defined when AHI was 5-30 (n = 38, OSA+), severe-when AHI was >30 (n = 43, OSA++). Individuals with AHI<5 (n = 31) served as control group (OSA-). RESULTS: Aß 1-40 concentrations in OSA++ (191.1 pg/ml) group was significantly (p<0.05) higher compared with OSA- (76.9 pg/ml) and OSA+ (159.4 pg/ml) and correlated with selected parameters of hypoxemia severity. There were no differences in Aß 1-42 concentration between the groups. CONCLUSION: In patients with severe OSA Aß 1-40 plasma concentrations are significantly higher compared with OSA- and OSA+ and seem to be related to hypoxia severity, which may indicate increased risk of AD development in this group of patients.

Circulating Endothelial Microparticles and Aortic Stiffness in Patients with Type 2 Diabetes Mellitus.

Diabetes mellitus represents a metabolic disorder the incidence of which has been on the increase in recent years. The well-known long-term complications of this disease encompass a wide spectrum of renal, neurological and cardiovascular conditions. The aim of the study was to investigate the serum concentration of endothelial microparticles (EMPs) as well as selected noninvasive parameters of the ascending aorta stiffness calculated with echocardiography. In this study, 58 patients were enrolled-38 subjects diagnosed with type 2 diabetes mellitus (T2DM) and 20 healthy controls. The analyzed populations did not differ significantly with respect to age, renal function, systolic and diastolic blood pressure. The patients with diabetes and concomitant hypertension presented higher levels of EMPs in comparison with diabetic normotensive subjects. Among patients with diabetes and hypertension, aortic stiffness assessed with the elasticity index (Ep) was higher and the aortic compliance index (D) lower than in the diabetic normotensive group. No correlation between the amount of EMPs and lipid profile, C-reactive protein (CRP) level and glycemia, was observed in the studied group. There was, however, a statistically significant positive correlation between the creatinine level and amount of EMPs, while the negative relationship was documented for EMPs level and the estimated glomerular filtration rate (eGFR).