Elevations in neutrophils with obstructive sleep apnea: The Multi-Ethnic Study of Atherosclerosis (MESA)

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:257

Article

Geovanini, Glaucylara Reis¹  Wang, Rui¹  Weng, Jia¹  Tracy, Russell²  Jenny, Nancy S.³  Goldberger, Ary L.⁴  Costa, Madalena D.⁴  Liu, Yongmei⁵  Libby, Peter⁶  Redline, Susan^1,7 

[1] Harvard Med Sch, Brigham & Womens Hosp, Div Sleep & Circadian Disorders, Dept Med, Boston, MA 02115 USA

[2] Univ Vermont, Dept Biochem, Larner Coll Med, Burlington, VT 05405 USA

[3] Univ Vermont, Dept Pathol & Lab Med, Larner Coll Med, Burlington, VT USA

[4] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Margret & HA Rey Inst Nonlinear Dynam Med, Boston, MA 02115 USA

[5] Wake Forest Univ, Div Publ Hlth Sci, Sch Med, Dept Epidemiol & Prevent, Winston Salem, NC 27109 USA

[6] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Cardiovasc Div, Boston, MA 02115 USA

[7] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02115 USA

关键词: Neutrophils;    Granulocytes;    Polymorphonuclearleukocytes;    Sleep apnea;    Hypoxia;    Heart rate;   

DOI  :  10.1016/j.ijcard.2017.10.121

来源: Elsevier

【 摘 要 】

Background: Obstructive sleep apnea (OSA) associates with increased risk of cardiovascular diseases (CVD). Immune abnormalities and surges in sympathetic activity accompany OSA and CVD. We hypothesized that OSA associates with leukocytosis partially by abnormalities in autonomic nervous system (ANS) function that would suggest a pathway linking OSA and CVD. Methods: Participants from the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort of individuals initially without overt CVD, underwent polysomnography and assays for white blood cells (WBC) and subsets. Heart rate (HR) and heart rate variability (HRV), indirect measurements of ANS, were obtained from overnight electrocardiography. A formal statistical mediation analysis tested the indirect effect that mean HR and HRV measures contribute to associations between OSA and leukocytosis. Results: The analytical sample consisted of 1298 participants (54% female), ages 54-93 years, 14% with severe OSA (apnea-hypopnea-index, AHI >= 30). Severe OSA associated with a higher prevalence of obesity, diabetes, and increased levels of WBC total and subsets. Neutrophil count associated with severe OSA after adjusting for confounders (p= 0.017). Mean HR positively associated with OSA indices and neutrophils. A mediation analysis revealed an indirect effect of mean HR that explained an estimated 11% of the association between AHI and neutrophils. Overnight hypoxia also associated with neutrophil count (p = 0.009), and mean HR explained 14% of the association between neutrophils and hypoxia. Conclusions: In the MESA cohort, OSA measures associate with elevated neutrophil counts and increases in overnight mean HR. These data link innate immune dysregulation with OSA and provide a potential pathophysiologic pathway between CVD and OSA. (c) 2017 Elsevier B. V. All rights reserved.

【 授权许可】

Free