Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta‐Analysis and Meta-Regression

(1) Introduction: High sensitivity C-reactive protein (hs-CRP) and CRP are inflammatory biomarkers associated with several inflammatory diseases. In both pediatric and adult individuals with Obstructive Sleep Apnea (OSA) higher hs-CRP and CRP were observed, compared to controls. With the present sys...

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Main Authors: Mohammad Moslem Imani, Masoud Sadeghi, Farid Farokhzadeh, Habibolah Khazaie, Serge Brand, Kenneth M. Dürsteler, Annette Brühl, Dena Sadeghi-Bahmani
Format: Article
Language:English
Published: MDPI AG 2021-04-01
Series:Life
Subjects:
Online Access:https://www.mdpi.com/2075-1729/11/4/362
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language English
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author Mohammad Moslem Imani
Masoud Sadeghi
Farid Farokhzadeh
Habibolah Khazaie
Serge Brand
Kenneth M. Dürsteler
Annette Brühl
Dena Sadeghi-Bahmani
spellingShingle Mohammad Moslem Imani
Masoud Sadeghi
Farid Farokhzadeh
Habibolah Khazaie
Serge Brand
Kenneth M. Dürsteler
Annette Brühl
Dena Sadeghi-Bahmani
Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta‐Analysis and Meta-Regression
Life
<b>Keywords<i>:</i></b> obstructive sleep apnea
inflammation
C-reactive protein
children
adults
meta-analysis
author_facet Mohammad Moslem Imani
Masoud Sadeghi
Farid Farokhzadeh
Habibolah Khazaie
Serge Brand
Kenneth M. Dürsteler
Annette Brühl
Dena Sadeghi-Bahmani
author_sort Mohammad Moslem Imani
title Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta‐Analysis and Meta-Regression
title_short Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta‐Analysis and Meta-Regression
title_full Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta‐Analysis and Meta-Regression
title_fullStr Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta‐Analysis and Meta-Regression
title_full_unstemmed Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta‐Analysis and Meta-Regression
title_sort evaluation of blood levels of c-reactive protein marker in obstructive sleep apnea: a systematic review, meta‐analysis and meta-regression
publisher MDPI AG
series Life
issn 2075-1729
publishDate 2021-04-01
description (1) Introduction: High sensitivity C-reactive protein (hs-CRP) and CRP are inflammatory biomarkers associated with several inflammatory diseases. In both pediatric and adult individuals with Obstructive Sleep Apnea (OSA) higher hs-CRP and CRP were observed, compared to controls. With the present systematic review, meta-analysis and meta-regression we expand upon previous meta-analyses in four ways: (1) We included 109 studies (96 in adults and 13 in children); (2) we reported subgroup and meta-regression analyses in adults with OSA compared to controls on the serum and plasma levels of hs-CRP; (3) we reported subgroup and meta-regression analyses in adults with OSA compared to controls on the serum and plasma levels of CRP; (4) we reported serum and plasma levels of both hs-CRP and CRP in children with OSA, always compared to controls. (2) Materials and Methods: The PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases were searched to retrieve articles published until 31 May 2020, with no restrictions. The data included basic information involving the first author, publication year, country of study, ethnicity of participants in each study, age, BMI, and AHI of both groups, and mean and standard deviation (SD) of plasma and serum levels of CRP and hs-CRP. (3) Results: A total of 1046 records were retrieved from the databases, and 109 studies were selected for the analysis (96 studies reporting the blood levels of hs-CRP/CRP in adults and 13 studies in children). For adults, 11 studies reported plasma hs-CRP, 44 serum hs-CRP, 9 plasma CRP, and 32 serum CRP levels. For children, 6 studies reported plasma hs-CRP, 4 serum hs-CRP, 1 plasma CRP, and 2 serum CRP levels. Compared to controls, the pooled MD of plasma hs-CRP levels in adults with OSA was 0.11 mg/dL (<i>p</i> < 0.00001). Compared to controls, the pooled MD of serum hs-CRP levels in adults with OSA was 0.09 mg/dL (<i>p</i> < 0.00001). Compared to controls, the pooled MD of plasma CRP levels in adults with OSA was 0.06 mg/dL (<i>p</i> = 0.72). Compared to controls, the pooled MD of serum CRP levels in adults with OSA was 0.36 mg/dL (<i>p</i> < 0.00001). Compared to controls, the pooled MD of plasma hs-CRP, serum hs-CRP, plasma hs-CRP, and serum hs-CRP in children with OSA was 1.17 mg/dL (<i>p</i> = 0.005), 0.18 mg/dL (<i>p</i> = 0.05), 0.08 mg/dL (<i>p</i> = 0.10), and 0.04 mg/dL (<i>p</i> = 0.33), respectively. The meta-regression showed that with a greater apnea-hypapnea index (AHI), serum hs-CRP levels were significantly higher. (4) Conclusions: The results of the present systematic review, meta-analysis and meta-regression showed that compared to healthy controls plasma and serum levels of hs-CRP and serum CRP level were higher in adults with OSA; for children, and compared to controls, just plasma hs-CRP levels in children with OSA were higher.
topic <b>Keywords<i>:</i></b> obstructive sleep apnea
inflammation
C-reactive protein
children
adults
meta-analysis
url https://www.mdpi.com/2075-1729/11/4/362
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spelling doaj-de55917d052f42b5a28f9170dffd3b392021-04-19T23:04:03ZengMDPI AGLife2075-17292021-04-011136236210.3390/life11040362Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta‐Analysis and Meta-RegressionMohammad Moslem Imani0Masoud Sadeghi1Farid Farokhzadeh2Habibolah Khazaie3Serge Brand4Kenneth M. Dürsteler5Annette Brühl6Dena Sadeghi-Bahmani7Department of Orthodontics, Kermanshah University of Medical Sciences, Kermanshah 6715847141, IranMedical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, IranStudents Research Committee, Kermanshah University of Medical Sciences, Kermanshah 6715847141, IranSleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, IranSleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, IranPsychiatric Clinics, Division of Substance Use Disorders, University of Basel, 4002 Basel, SwitzerlandCenter for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, SwitzerlandSleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran(1) Introduction: High sensitivity C-reactive protein (hs-CRP) and CRP are inflammatory biomarkers associated with several inflammatory diseases. In both pediatric and adult individuals with Obstructive Sleep Apnea (OSA) higher hs-CRP and CRP were observed, compared to controls. With the present systematic review, meta-analysis and meta-regression we expand upon previous meta-analyses in four ways: (1) We included 109 studies (96 in adults and 13 in children); (2) we reported subgroup and meta-regression analyses in adults with OSA compared to controls on the serum and plasma levels of hs-CRP; (3) we reported subgroup and meta-regression analyses in adults with OSA compared to controls on the serum and plasma levels of CRP; (4) we reported serum and plasma levels of both hs-CRP and CRP in children with OSA, always compared to controls. (2) Materials and Methods: The PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases were searched to retrieve articles published until 31 May 2020, with no restrictions. The data included basic information involving the first author, publication year, country of study, ethnicity of participants in each study, age, BMI, and AHI of both groups, and mean and standard deviation (SD) of plasma and serum levels of CRP and hs-CRP. (3) Results: A total of 1046 records were retrieved from the databases, and 109 studies were selected for the analysis (96 studies reporting the blood levels of hs-CRP/CRP in adults and 13 studies in children). For adults, 11 studies reported plasma hs-CRP, 44 serum hs-CRP, 9 plasma CRP, and 32 serum CRP levels. For children, 6 studies reported plasma hs-CRP, 4 serum hs-CRP, 1 plasma CRP, and 2 serum CRP levels. Compared to controls, the pooled MD of plasma hs-CRP levels in adults with OSA was 0.11 mg/dL (<i>p</i> < 0.00001). Compared to controls, the pooled MD of serum hs-CRP levels in adults with OSA was 0.09 mg/dL (<i>p</i> < 0.00001). Compared to controls, the pooled MD of plasma CRP levels in adults with OSA was 0.06 mg/dL (<i>p</i> = 0.72). Compared to controls, the pooled MD of serum CRP levels in adults with OSA was 0.36 mg/dL (<i>p</i> < 0.00001). Compared to controls, the pooled MD of plasma hs-CRP, serum hs-CRP, plasma hs-CRP, and serum hs-CRP in children with OSA was 1.17 mg/dL (<i>p</i> = 0.005), 0.18 mg/dL (<i>p</i> = 0.05), 0.08 mg/dL (<i>p</i> = 0.10), and 0.04 mg/dL (<i>p</i> = 0.33), respectively. The meta-regression showed that with a greater apnea-hypapnea index (AHI), serum hs-CRP levels were significantly higher. (4) Conclusions: The results of the present systematic review, meta-analysis and meta-regression showed that compared to healthy controls plasma and serum levels of hs-CRP and serum CRP level were higher in adults with OSA; for children, and compared to controls, just plasma hs-CRP levels in children with OSA were higher.https://www.mdpi.com/2075-1729/11/4/362<b>Keywords<i>:</i></b> obstructive sleep apneainflammationC-reactive proteinchildrenadultsmeta-analysis