Miquel Félez1, Nuria Grau2, Antonia Ruiz3, Encarna Guardiola3, Carles Sanjuas2, Cristina Estirado4, Maribel Navarro-Muñoz5, Antoni Pascual6, Mauricio Orozco-Levi7, Joaquim Gea4. 1. Unidad Multidisciplinar de Trastornos del Sueño, Hospital del Mar, Parc de Salut Mar, UAB-UPF, Barcelona, España; Servicio de Neumología, Hospital del Mar, Parc de Salut Mar, IMIM, UAB-UPF, CIBERES, ISC III, Barcelona, España. Electronic address: 91435@hospitaldelmar.cat. 2. Unidad Multidisciplinar de Trastornos del Sueño, Hospital del Mar, Parc de Salut Mar, UAB-UPF, Barcelona, España; Servicio de Neumología, Hospital del Mar, Parc de Salut Mar, IMIM, UAB-UPF, CIBERES, ISC III, Barcelona, España. 3. Unidad Multidisciplinar de Trastornos del Sueño, Hospital del Mar, Parc de Salut Mar, UAB-UPF, Barcelona, España. 4. Servicio de Neumología, Hospital del Mar, Parc de Salut Mar, IMIM, UAB-UPF, CIBERES, ISC III, Barcelona, España. 5. Group of Integrative Pharmacology and Systems Neuroscience, Neurosciences Programme, IMIM (Hospital del Mar Medical Research Institute), Parc de Recerca Biomèdica de Barcelona, Barcelona, España. 6. Group of Integrative Pharmacology and Systems Neuroscience, Neurosciences Programme, IMIM (Hospital del Mar Medical Research Institute), Parc de Recerca Biomèdica de Barcelona, Barcelona, España; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona, Barcelona, España. 7. Servicio de Neumología, Fundación Cardiovascular de Colombia, Hospital Internacional de Colombia, Bucaramanga, Colombia.
Abstract
INTRODUCTION: Tissue hypoxia stimulates the production of erythropoietin (EPO), the main effect of which is, in turn, to stimulate erythropoiesis. Sleep apnea-hypopnea syndrome (SAHS) is an entity characterized by repeated episodes of hypoxemia during sleep. OBJECTIVE: To analyze whether hypoxemia stimulated increased urinary excretion of EPO, and if so, to evaluate if treatment with continuous positive airway pressure (CPAP) can inhibit this phenomenon. METHODS: We studied 25 subjects with suspected SAHS who underwent a polysomnography study (PSG). EPO levels in first morning urine (uEPO) and blood creatinine and hemoglobin were determined in all patients. Patients with severe SAHS repeated the same determinations after CPAP treatment. RESULTS: Twelve subjects were diagnosed with severe SAHS (mean ± SD, AHI 53.1 ± 22.7). Creatinine and hemoglobin levels were normal in all subjects. uEPO was 4 times higher in the SAHS group than in the control group (1.32 ± 0.83 vs. 0.32 ± 0.35 UI/l, p <.002). CPAP treatment reduced uEPO to 0.61 ± 0.9 UI/l (p <.02), levels close to those observed in healthy subjects. No dose-response relationship was observed between severity of PSG changes and uEPO values. CONCLUSIONS: Patients with severe SAHS show increased uEPO excretion, but this normalizes after treatment with CPAP.
INTRODUCTION: Tissue hypoxia stimulates the production of erythropoietin (EPO), the main effect of which is, in turn, to stimulate erythropoiesis. Sleep apnea-hypopnea syndrome (SAHS) is an entity characterized by repeated episodes of hypoxemia during sleep. OBJECTIVE: To analyze whether hypoxemia stimulated increased urinary excretion of EPO, and if so, to evaluate if treatment with continuous positive airway pressure (CPAP) can inhibit this phenomenon. METHODS: We studied 25 subjects with suspected SAHS who underwent a polysomnography study (PSG). EPO levels in first morning urine (uEPO) and blood creatinine and hemoglobin were determined in all patients. Patients with severe SAHS repeated the same determinations after CPAP treatment. RESULTS: Twelve subjects were diagnosed with severe SAHS (mean ± SD, AHI 53.1 ± 22.7). Creatinine and hemoglobin levels were normal in all subjects. uEPO was 4 times higher in the SAHS group than in the control group (1.32 ± 0.83 vs. 0.32 ± 0.35 UI/l, p <.002). CPAP treatment reduced uEPO to 0.61 ± 0.9 UI/l (p <.02), levels close to those observed in healthy subjects. No dose-response relationship was observed between severity of PSG changes and uEPO values. CONCLUSIONS:Patients with severe SAHS show increased uEPO excretion, but this normalizes after treatment with CPAP.
Keywords:
CPAP; Eritropoyetina en orina; Erythropoietin in urine; Presión positiva continua de la vía aérea; Sleep apnea-hypopnea syndrome; Síndrome de apneas-hipopneas del sueño
Authors: Daniel Morell-Garcia; Núria Toledo-Pons; Pilar Sanchis; Josep Miquel Bauça; José María Sánchez; José Peña-Zarza; Paloma Giménez; Javier Pierola; Mónica de la Peña-Bravo; Alberto Alonso-Fernández; Antònia Barceló Journal: ERJ Open Res Date: 2020-10-05
Authors: Irina M Madaeva; Olga N Berdina; Nadezhda A Kurashova; Natalya V Semenova; Erdem B Ukhinov; Aleksey V Belskikh; Lyubov I Kolesnikova Journal: Neurol Ther Date: 2021-10-20