A Case-Control Study on the Changes in High-Sensitivity C-Reactive Protein and Tumor Necrosis Factor-Alpha Levels with Surgical Treatment of OSAS

Abstract

Obstructive sleep apnea syndrome (OSAS) is a common but underdiagnosed condition with significant health and economic implications for society. Inflammatory mediators are proposed to be associated with the presence and severity of OSAS and contribute to morbidity and mortality. This paper details a prospective non-randomized case control study of a cohort of subjects, who underwent surgical treatment of OSAS and were enrolled to assess the sleep parameters and blood levels of selected inflammatory markers at pre-operative and post-operative time points, also comparing them to the levels in a control group. A total of 25 study subjects and 18 control subjects were enrolled. Median values and interquartile range (IQR) of the apnea–hypopnea index (AHI) in the study group pre-operatively and post-operatively were 34 (18.5–45.5) and 13.3 (7.5–27.3), while in the control group 1.4 (1.0–2.1) per hour. The mean (IQR) hs-CRP levels (mg/L) were 1.782 (0.941–5.594) and 1.980 (0.990–5.445) in the study group, pre-operatively and post-operatively, respectively, while 0.891 (0.767–1.436) in the control group. The mean (IQR) TNF-α levels (pg/mL) were 7.999 (6.137–9.216) and 6.614 (5.534–7.460) pre-and post-operatively, respectively, and were 6.000 (5.026–6.823) in the control group. Results demonstrated that both inflammatory markers, hs-CRP and TNF-α, are higher in subjects with OSAS compared to the controls, and their levels decrease, but are still higher than the controls, after successful surgical treatment. Further analysis including the body mass index and age demonstrated that these changes were significant for TNF-α, but not hs-CRP.