RT Journal Article
SR Electronic
T1 Vasopressin, atrial natriuretic peptide and adrenomedullin as markers of hypoxic stress in patients with obstructive sleep apnoea syndrome
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P313
VO 42
IS Suppl 57
A1 Peter Grendelmeier
A1 Werner Strobel
A1 Thomas Schmid
A1 Kathleen Jahn
A1 Michael Tamm
A1 Daiana Stolz
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P313.abstract
AB Background: Hypoxia has been suggested to increase circulating vasopressin and atrial natriuretic peptide (ANP) concentrations as well as up-regulate adrenomedulin (ADM) expression via the HIF-1 pathway. We hypothesize that intermittent chronic hypoxia within obstructive sleep apnoea syndrome (OSAS) leads to an increase of these peptides and that their circulating levels correlate with clinical important outcomes.Methods: Prospectively, longitudinal multicentre study including 250 patients with suspected OSAS undergoing a diagnostic work-up in a dedicated sleep laboratory. Vasopressin precursor copeptin (AVP), ANP and ADM levels were assessed at baseline, 1 and 6 months after institution of CPAP therapy.Results: Baseline data of 150 patients (54.1 ± 13.6 years, 69% male, BMI 32 ± 6) have been analyzed so far. Median [95% CI] ODI was 14 [6-27] and AHI was 17 [10-31]. There was a significant correlation between the AHI with AVP (rho 0.261, p=0.006), ADM (rho 0.285, p=0.002) and ANP (rho 0.218, p=0.021). In contrast, the ODI correlated with AVP (rho 0.265, p=0.005) and ADM (rho 0.226,p=0.018) but not ANP (rh0 0.104, p=0.280). Circulating values of all three peptides were higher in patients with diagnosed OSAS as compared to those with a normal polygraphy/polysomnography. AVP provided the highest differentiation between the two patients groups (7.7 nmol/L [5.1-11.1] vs. 4.9 nmol/L [2.8-5.4], p=0.002) with an AUC for the identification of patients with OSAS of 0.760 [0.614-0.905], p=0.002.Conclusions: Vasopressin, adrenomedullin and atrial natriuretic peptide correlate with the severity of OSAS and might be potential markers of therapeutic success.