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Open AccessArticle

Obstructive Sleep Apnea and Circulating Biomarkers of Oxidative Stress: A Cross-Sectional Study

Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada
Leon Judah Blackmore Sleep Disorders Program, UBC Hospital, Vancouver, BC V6T 2B5, Canada
Canadian Sleep and Circadian Network, Montréal, QC H4J 1C5, Canada
Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2A1, Canada
Author to whom correspondence should be addressed.
Antioxidants 2020, 9(6), 476;
Received: 12 May 2020 / Revised: 26 May 2020 / Accepted: 29 May 2020 / Published: 2 June 2020
(This article belongs to the Special Issue Feature Papers in Antioxidants in 2020)
Oxidative stress (OS) drives cardiometabolic diseases. Intermittent hypoxia consistently increases oxidative stress markers. Obstructive sleep apnea (OSA) patients experience intermittent hypoxia and an increased rate of cardiovascular disease, however, the impact of OSA on OS markers is not clear. The objective was to assess relationships between OSA severity and biomarker levels. Patients with suspected OSA referred for a polysomnogram (PSG) provided fasting blood sample. Plasma levels of 8-isoprostane, 8-hydroxydeoxyguanosine (8-OHdG), and superoxide dismutase (SOD) were measured. The relationship between OSA and OS was assessed both before and after controlling for confounders (age, sex, smoking history, history of cardiovascular disease, ethnicity, diabetes, statin usage, body mass index (BMI)). 402 patients were studied (68% male, mean age ± SD = 50.8 ± 11.8 years, apnea-hypopnea index (AHI) = 22.2 ± 21.6 events/hour, BMI = 31.62 ± 6.49 kg/m2). In a multivariable regression, the AHI significantly predicted 8-isoprostane levels (p = 0.0008) together with age and statin usage; AHI was not a predictor of 8-OHdG or SOD. Female sex (p < 0.0001) and no previous history of cardiovascular disease (p = 0.002) were associated with increased antioxidant capacity. Circulating 8-isoprostane levels may be a promising biomarker of the severity of oxidative stress in OSA patients. Prospective studies are needed to determine whether this biomarker is associated with long-term cardiometabolic complications in OSA. View Full-Text
Keywords: obstructive sleep apnea (OSA); biomarkers; oxidative stress obstructive sleep apnea (OSA); biomarkers; oxidative stress
MDPI and ACS Style

Peres, B.U.; Allen, A.H.; Shah, A.; Fox, N.; Laher, I.; Almeida, F.; Jen, R.; Ayas, N. Obstructive Sleep Apnea and Circulating Biomarkers of Oxidative Stress: A Cross-Sectional Study. Antioxidants 2020, 9, 476.

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