[The correlation of interleukin 2 and interleukin 4 with alterations in the brachiocephalic arteries in patients with obstructive sleep apnea].

Abstract

Objective: To evaluate the relationship between interleukin 2 (IL-2) and interleukin 4 (IL-4) and the alterations occurring in the extracranial levels of arteries of patients with obstructive sleep apnea (OSA).

Material and methods: A total of 65 subjects participated in the study, comprising 40 males (61.5%) and 25 females (38.5%), with a mean age of 52.86±9.75 years. The subjects were categorized into two distinct groups: the main group, consisting of 37 patients with OSA and an apnea-hypopnea index (AHI) of more than 15 episodes per hour, and the control group, consisting of 28 subjects without OSA and an AHI of less than 5 episodes per hour. The diagnostic procedure for all subjects encompassed anthropometric measurements, polysomnography, and ultrasound imaging of the brachiocephalic arteries (BCA). The assessment of chronic cerebral ischemia (CCI) and hypertension (HTN) was conducted. IL-2 and IL-4 levels were measured using enzyme-linked immunosorbent assay.

Results: Among patients diagnosed with OSA, CCI was detected in 75.7% of cases, and atherosclerotic changes in the BCA were observed in 89.2%. Furthermore, these patients presented with a bilateral increase in the diameters of the common carotid artery (CCA) and the internal carotid artery (ICA) (p<0.05), alongside a noted increase in IL-2 levels and a significantly reduced IL-4 levels. In the main group, a positive correlation was established between the diameter of the left ICA and IL-4 (r=0.421, p=0.009), as well as between the diameter of the right ICA and IL-4 (r=0.482, p=0.003). A positive association was also observed between the detected atherosclerotic alterations and neck circumference (r=0.269, p=0.030), AHI (r=0.255, p=0.041), HTN (r=0.336, p=0.006), and CCI (r=0.255, p=0.041).

Conclusions: The findings of this study demonstrate that patients with OSA exhibit increasingly persistent and significant abnormalities in the extracranial arteries as the pathological process advances. The noted dilation of the ICA and the CCA in the main group is likely due to vascular remodeling and reduced IL-4 levels. The established correlation between atherosclerotic changes in the BCA and metrics such as neck circumference, AHI, HTN, and CCI suggests that OSA may directly induce pathological processes in vascular walls, thereby contributing to the emergence of comorbid conditions. The absence of a definitive link between BCA atherosclerosis and IL-4 levels in OSA patients may be attributable to the relatively small sample size, warranting further research.