%0 Journal Article
%T Elevated Serum C-Reactive Protein and Markers of Sleep Disordered Breathing
%A R. Constance Wiener
%A Rouxin Zhang
%A Anoop Shankar
%J International Journal of Vascular Medicine
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/914593
%X Background. Previous studies indicated sleep-disordered breathing (SDB) is associated with cardiovascular disease (CVD). Systemic inflammation is recognized as a risk factor for CVD. Studies examining SDB and inflammation are limited. Methods. We studied sleep duration, snoring, snorting, and daytime sleepiness, and an additive SDB score. The main outcome was a C-reactive protein (CRP) of >1£¿mg/dL. Results. Snoring, snorting, daytime sleepiness, and sleeping >7 or <7 hours, and the additive score were significantly associated with high CRP. The additive score was not associated in men but moderately associated in women in a multivariable model adjusting for age, gender, race/ethnicity, education, smoking, hypertension, alcohol intake, physical activity, body mass index, depression, diabetes, hypertension, and total cholesterol (P-interaction£¿ ). For race/ethnicity, the association was strongest in Mexican Americans/others, modest in Non-Hispanic whites, and absent in Non-Hispanic blacks (P-interaction£¿ ). Conclusions. The association between SDB and high CRP was present mainly in women and Mexican Americans, implying SDB has a residual, independent association with inflammation after controlling for lifestyle and metabolic risk factors like BMI, physical activity, depression, diabetes, and cholesterol. 1. Introduction Sleep-disordered breathing (SDB) is a common, chronic disorder in which there is sleep-related repeated upper airway collapse resulting in episodes of hypoxemia and arousal [1]. Nationwide, SDB affects approximately 12¨C18 million people, nearly 4% of the population [2]. SDB is described as markedly undiagnosed [3] (especially in women [4]). SDB is a public health concern as it has been associated with cardiovascular disease (CVD) [5], motor vehicle crashes, [3, 6, 7] neuropsychological deficits [8], and mortality [9]. Recent US and Japanese studies have shown an association between SDB markers and C-reactive protein (CRP), a biomarker of inflammation and predictor of future risk of CVD [10¨C13]. For example, strong positive associations occurred in a study of 69 healthy men, controlling for age, BMI, waist circumference, and percent body fat [1]. Also, a study of 18 men and 4 women showed elevated CRP levels with newly diagnosed obstructive sleep apnea in a multivariate analysis controlling for age, sex, BMI, smoking, alcohol, LDL, and HDL [10]. A study of 30 men with newly diagnosed obstructive sleep apnea and 14 obese controls showed higher CRP in those with obstructive sleep apnea than the obese controls. However, the studies were small
%U http://www.hindawi.com/journals/ijvm/2012/914593/