Impact of severe OSA during REM sleep on cardiac and inflammatory protein levels

Background: Proteomic-based technologies offer new possibilities to identify altered levels of cardiac and inflammatory proteins that might reflect the cardiometabolic stress caused by different measures of OSA. Aim: To investigate the effects of OSA on the cardiovascular system by analysing a broad panel of cardiac and inflammatory proteins in relationship to different measures of OSA in a population based cohort of women. Method: In the “Sleep and Health in Women” (SHE) cohort study, 400 women underwent polysomnography, anthropometric measurements and blood sampling. Two proteomic assays (Olink Proseek® Inflammation panel and Cardiovascular II panel), each measuring 92 proteins, were analysed in a subsample of 253 women. Results: In unadjusted models, with false discovery rate set to 10%, 57 proteins were associated with AHI, 56 proteins with ODI and 64 proteins with REM AHI. After adjustment for age, BMI and plate there were no significant associations between AHI or ODI and any of the proteins. REM AHI>30 was associated with decreased levels of two proteins involved in anti-inflammatory processes; Sirt2 (q-value 0.016) and LAP-TGFs1 (q-value 0.016). There was further a negative association between REM AHI>30 and Axin1 (q-value 0.095), a protein known to facilitate TGFs signalling. Conclusion: Severe OSA during REM sleep affected the plasma levels of Sirt2, LAP-TGFs1 and Axin1. For overall AHI and ODI the associations with cardiac and inflammatory proteins were weaker and to a large extent explained by age and BMI.