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Published on: December 6, 2016
Serum matrix metalloproteinase-9 as a potential biomarker for obstructive sleep apnea severity
So Yeon Kim1, Hyunyee Yoon2, Seung Ho Choi3
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Purpose:
We aimed to investigate the associations between serum matrix metalloproteinase (MMP)-2 and MMP-9 levels and obstructive sleep apnea (OSA) severity with a focus on nocturnal hypoxemia.
Methods:
The OSA patients (n = 105) were recruited from a prospective sleep apnea cohort after polysomnography, with 27 healthy volunteers as the controls. OSA severity was assessed via the apnea-hypopnea index (AHI) and percent night time with SpO2 < 90% (T90).
Results:
The serum MMP-9 levels were significantly higher in the OSA patients (AHI ≥ 5/h, 68.8 ± 44.9 ng/mL) than the controls (49.0 ± 18.6 ng/mL, p < 0.001). The MMP-2 levels showed no significant differences. When grouped into T90 quartiles, the MMP-9 levels were higher in the OSA patients in the highest quartile compared to those in the lowest quartile or the controls (90.6 ± 56.3 ng/mL vs. 56.9 ± 31.9 ng/mL, p = 0.022; 90.6 ± 56.3 ng/mL vs. 49.0 ± 18.6 ng/mL, p = 0.002, respectively). The MMP-9 levels correlated with T90 and the AHI (r = 0.36, p < 0.001; r = 0.35, p < 0.001, respectively). Multiple linear regression confirmed a significant association between MMP-9 and T90 after adjusting for body mass index, smoking status, and comorbidities (β = 0.53, p = 0.013). A similar association was observed for the AHI (β = 0.48, p = 0.019).
Conclusion:
We concluded that serum MMP-9 levels are independently associated with OSA severity, particularly with T90 and the AHI, which suggests that MMP-9 could be a biomarker for OSA severity.
