Serum Levels of Vascular Endothelial Growth Factor and Insulin-like Growth Factor Binding Protein-3 in Obstructive Sleep Apnea Patients: Effect of Continuous Positive Airway Pressure Treatment



Kostas Archontogeorgis1, Evangelia Nena2, Nikolaos Papanas3, *, Maria Xanthoudaki1, Olga Hatzizisi4, Georgios Kyriazis4, Venetia Tsara4, Efstratios Maltezos3, Marios Froudarakis1, Paschalis Steiropoulos1
1 Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
2 Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
3 Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
4 Department of Pneumonology, General Hospital “G. Papanikolaou”, Thessaloniki, Greece


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© Archontogeorgis et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Second Department of Internal Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece; Fax: +302551074723; E-mail: papanasnikos@yahoo.gr


Abstract

Background and Aim:

Hypoxia, a major feature of obstructive sleep apnea (OSA), modifies Vascular Endothelial Growth Factor (VEGF) and Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) levels, which contribute to atherogenesis and occurrence of cardiovascular (CV) events. We assessed and compared serum levels of VEGF and IGFBP-3 in newly diagnosed OSA patients and controls, to explore associations with anthropometric and sleep parameters and to study the effect of continuous positive airway pressure (CPAP) treatment on these levels.

Materials and Methods:

Serum levels of VEGF and IGFBP-3 were measured in 65 OSA patients and 31 age- and body mass index- matched controls. In OSA patients, measurements were repeated after 6 months of CPAP therapy. All participants were non-smokers, without any comorbidities or systemic medication use.

Results:

At baseline, serum VEGF levels in OSA patients were higher compared with controls (p<0.001), while IGFBP-3 levels were lower (1.41±0.56 vs. 1.61±0.38 μg/ml, p=0.039). VEGF levels correlated with apnea-hypopnea index (r=0.336, p=0.001) and oxygen desaturation index (r=0.282, p=0.007). After 6 months on CPAP treatment, VEGF levels decreased in OSA patients (p<0.001), while IGFBP-3 levels increased (p<0.001).

Conclusion:

In newly diagnosed OSA patients, serum levels of VEGF are elevated, while IGFBP-3 levels are low. After 6 months of CPAP treatment these levels change. These results may reflect an increased CV risk in untreated OSA patients, which is ameliorated after CPAP therapy.

Keywords: Continuous positive airway pressure, hypoxia, insulin-like growth factor binding protein-3, obstructive sleep apnea, vascular endothelial growth factor, treatment.