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Serum endothelial cell specific molecule-1 (endocan) levels in patients with obstructive sleep apnea

Objective: To investigate the level of endothelial cell specific molecule-1 (endocan) in obstructive sleep apnea (OSA). Methods: Study group included subjects with OSA. Control group included subjects who had no OSA on polysomnography and nonobese healthy subjects from population who had no OSA symptoms. Endocan levels of OSA and non-OSA subjects were compared. Results: Totally 106 individuals (63 OSA, 43 non-OSA) were included. Endocan levels were higher in OSA subjects than controls (1.25 ± 0.4 ng/ml vs 0.93 ± 0.3 ng/ml, p < 0.001). Endocan levels were correlated with BMI (r = 0.456, p < 0.001) and daytime PaO2 (r = -0.266, p < 0.042). In linear regression analysis there was no factor related to endocan level. Conclusion: Serum endocan is significantly higher in OSA. Further studies should be performed to better understand the relationship between endocan and OSA. First draft submitted: 2 July 2015; Accepted for publication: 4 November 2015; Published online: 14 January 2016

Zuleyha Bingol1, Murat Kose2, Aylin Pıhtılı3, Timur Akpınar2, Tufan Tukek2 & Esen Kıyan*,1,2 Istanbul University, Istanbul Faculty of Medicine, Department of Pulmonary Medicine, 34360, Istanbul, Turkey 2 Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, 34360, Istanbul, Turkey 3 Istanbul Haydarpasa Numune Training and Research Hospital, Department of Pulmonary Medicine, 34668, Istanbul, Turkey *Author for correspondence: Fax: + 90 212 635 27 08 [email protected] 1

Keywords: endocan • endothelial cell-specific molecule-1 • endothelial dysfunction • obstructive sleep apnea

Obstructive sleep apnea (OSA) is characterized by repetitive collapse in the upper airway during sleep leading to apnea or hypopnea with oxygen desaturations. It is a common disease affecting middle-aged population and has been associated with a variety of cardiovascular disorders [1,2] . Most of the sequelae of OSA are strongly related to the distrupted sleep architecture, degree and duration of oxygen desaturation than to the numbers of apneas and hypopneas [3–5] . Both obesity and severe nocturnal intermittent hypoxia in OSA subjects lead to systemic inflammation and endothelial ­dysfunction  [3,6,7] . Endothelial cell specific molecule-1 also called as endocan is a dermatan sulfate proteoglycan, which is expressed by endothelial cells in alveolar walls of the lung and kidney [8,9] . Endocan expression was also detected in different epithelia and adipocytes [9–11] . Endocan levels are increased in inflammatory dis-

10.2217/bmm.15.117 © 2016 Future Medicine Ltd

eases with vascular endothelial involvement or endothelial dysfunction. Therefore, it is acceptable as a potential marker for endothelial dysfunction [12,13] . Previous studies showed that serum levels of endocan are related to the severity and prognosis in cardiovascular diseases and inflammatory diseases such as Behcet, psoriasis and sepsis [14–19] . There are few studies about endocan levels in lung diseases [20–24] . First, high serum endocan levels were found in lung cancer patients [20,21] . Next study found that endocan plays an active role in the pathogenesis of acute lung injury after trauma  [22] . A recent study reported higher endocan levels in pulmonary embolism and concluded that serum endocan can be used to determine the severity of pulmonary thromboembolism  [23] . Endocan level increases in community acquired pneumonia subjects and can be a marker for disease severity [24] . This study aimed to investigate the serum endocan levels in OSA, which is an inflam-

Biomark. Med. (2016) 10(2), 177–184

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ISSN 1752-0363


Research Article  Bingol, Kose, Pıhtılı, Akpınar, Tukek & Kıyan matory disease with endothelial dysfunction. Secondary aim was evaluating endocan levels in OSA subgroups such as OSA with nocturnal hypoxemia (NH), hypercapnia and comorbidities. Materials & methods This prospective study was conducted from December 2014 to February 2015. All of the subjects voluntarily signed their informed consent. The study was carried out according to the principles of the Helsinki Declaration. It was approved by the Istanbul University Istanbul Medical Faculty Institutional Board (ethic no: 2014/1716). We studied consecutive subjects who were admitted to the sleep laboratory due to suspicion of sleep apnea. Subjects with OSA were accepted as a study group. OSA was diagnosed if the apnea hypopnea index (AHI) was ≥5/h and the presence of clinical symptoms or AHI ≥15/h without any symptoms. Subjects with AHI

Serum endothelial cell specific molecule-1 (endocan) levels in patients with obstructive sleep apnea.

To investigate the level of endothelial cell specific molecule-1 (endocan) in obstructive sleep apnea (OSA)...
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