Interactions among Obstructive Sleep Apnea Syndrome Severity, Sex, and Obesity on Circulatory Inflammatory Biomarkers in Patients with Suspected Obstructive Sleep Apnea Syndrome: A Retrospective, Cross-Sectional Study.

The interaction among obstructive sleep apnea syndrome (OSAS) severity, sex, and obesity on cardiovascular risk as determined by serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) remains unclear. Therefore, this study aimed to analyze individual associations between these three OSAS characteristics and three cardiovascular biomarkers and to determine whether the relationship was affected by other features in patients with suspected OSAS. For all participants (n = 100), OSAS severity and sex had an interaction effect on IL-6 level (p = 0.030). Specifically, the male patients (p = 0.005) with severe OSAS had higher IL-6 levels than those with normal to moderate OSAS, but this relationship was not significant in the female patients (p = 0.438). Moreover, in patients with normal to moderate OSAS (p = 0.004), but not in those with severe OSAS (p = 0.824), the female patients had higher IL-6 levels than the male patients. Both CRP (p = 0.001) and IL-6 (p = 0.000) levels were higher in the obese group than in the non-obese group independently of OSAS severity and sex. The three features had no effects on TNF-α level individually and interactively. Our findings suggest that circulatory inflammatory markers should be comprehensively evaluated in this population and that treatment and preventive therapies should be modified accordingly.