Endothelial and Angiogenic Biomarkers in Obstructive Sleep Apnea: Longitudinal Associations With Continuous Positive...

Area of Science:

• Cardiovascular research
• Sleep medicine
• Biomarker analysis

Background:

• Obstructive sleep apnea (OSA) is linked to cardiovascular risks.
• Continuous positive airway pressure (CPAP) is a primary OSA treatment.
• Long-term effects of CPAP on vascular biomarkers in non-comorbid OSA patients are unclear.

Purpose of the Study:

• To investigate the longitudinal associations of CPAP use with endothelial and epithelial biomarkers in OSA patients without pre-existing cardiovascular disease.
• To assess the impact of CPAP therapy on vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2) levels over five years.

Main Methods:

• The EPIOSA study enrolled moderate-to-severe OSA patients and controls in a 5-year prospective cohort.
• Plasma levels of Ang-2, VEGF, Tie-2, and E-selectin were measured at baseline, 1 year, and 5 years.
• Multivariable regression models analyzed associations between biomarkers and clinical, sleep, and biochemical variables.

Main Results:

• CPAP-treated OSA patients exhibited sustained reductions in VEGF, linked to baseline VEGF and waist-to-hip ratio.
• Angiopoietin-2 (Ang-2) levels increased in both OSA and control groups, independent of CPAP.
• Tie-2 and E-selectin showed minimal changes; body weight and sST2 predicted baseline Ang-2.

Conclusions:

• Long-term CPAP therapy in OSA patients attenuates hypoxia-driven VEGF pathways.
• CPAP does not alter Ang-2 trajectories, indicating non-hypoxic vascular risks in OSA.
• Further research is needed to explore non-hypoxic mechanisms contributing to vascular risk in OSA.