Serum resistin level in obstructive sleep apnea patients complicated with cardiac diseases, diabetes mellitus or renal impairment

Background: Obstructive sleep apnea (OSA) has been independently associated with cardiovascular diseases, including hypertension, coronary heart disease and heart failure. Also, it had a deleterious impact on renal function and a link to diabetes mellitus (DM) and insulin resistance. Resistin is new adipokine and may play a role in cardiac, diabetics and renal patients. Aim of the work: The aim of this work is screening of cardiac dysfunction, DM and renal impairment in OSA patients and to study the role of resistin serum level in occurrence of these complications. Subjects and methods: This study was carried out on 10 control persons (group I) and 143 patients with OSA (group II). The following were done to all persons: body mass index (BMI), blood pressure measurement, fasting and post prandial blood sugar levels, serum creatinine and ECG, diagnostic sleep study, echocardiogram, estimated glomerular filtration rate (eGFR) and serum resistin assay. According to the above results, group II was divided into 4 subgroups, A (33OSAS patients), B (21 OSAS patients with cardiac troubles), C (40 OSAS patients with DM) and D (13 OSAS patients with renal impairment). 36 OSAS patients were excluded from the study because they had either 2 or more of the above abnormalities (cardiac, DM and renal). Results: There was significant increase of ESS and plasma resistin level in subgroups IIB, IIC and IID as compared group I and subgroup IIA which was significantly increased as compared to group I. There was no significant difference of BMI in subgroups IIA, IIB, IIC and IID but SaO2 and AHI were significantly increased in subgroups IIB, IIC and IID as compared to IIA. In group II, there was a significant positive correlation between plasma resistin level and AHI, SaO2 but there was no significant correlation between BMI and plasma resistin level. Conclusion: OSA patients can be complicated with cardiac diseases, DM and renal impairment through elevated resistin serum levels. Recommendation: Effect of CPAP on resistin serum level must be evaluated in these patients