Radostina Vlaeva Cherneva, Ognian Borisov Georgiev, Daniela Stoichkova Petrova, Emil Ivanov Mano, Adelina Dimitrova Tsakova and Julia Ivanova Petrova
Background: Patients with obstructive sleep apnea are more likely to have a non-dipping blood pressure profile than hypertensive patients without sleep apnea. The study of clinical factors and biomarkers affecting the nocturnal dip of blood pressure is of practical value.
Aim: To determine the role of glucometabolic, sleep study parameters and biomarkers in the detection of dipper and non-dipper obstructive sleep apnea patients.
Materials and Methods: A total of 87 patients participated in the study. Obstructive sleep apnea was verified by a standard polysomnography. Metabolic syndrome was diagnosed according to IDF, 2005. Anthropological parameters, glucmetabolic and sleep study characteristics were assessed. An ambulatory 24-hour blood pressure monitoring was performed. Resistin and free fatty acids plasma levels were measured. Urinary 8-isoprostanes were determined.
Results: Nondippers did not differ significantly from dippers regarding the anthromopetric measurements. From the sleep study parameters only the duration of sleep at SaO2<90% was longer in non-dippers (63.17 ± 30.32 vs 39.92 ± 34.89). Glucometabolic markers could not differentiate dippers from non-dippers, except for HbA1C (5.9 ± 0.5 vs 6.4 ± 1.05; p=0.006). The biomarkers – resistin, free fatty acids and isoprostanes were of similar range in both groups. The multivariate regression analysis, however showed that HbA1C lost its value as an independent predictor of non-dipping after adjustment for duration of sleep at SaO2<90%.
Conclusions: According to our study the average duration of sleep with SatO2<90% could be of clinical value in the prediction of the non-dipping phenomenon in patients with obstructive sleep apnea and metabolic syndrome.
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