The Correlation Between Obstructive Sleep Apnea Syndrome And Alzheimer’s Disease: A Meta-analysis

Objective:Obstructive sleep apnea syndrome(OSAS)is a systemic disease that can cause damage to the heart,brain and other organs.In recent years,it has been proved that OSAS may be a risk factor for neuronal degeneration in Alzheimer’s disease(AD).Compared with other risk factors of AD,OSAS can be diagnosed and treated in clinic.However,the pathophysiological mechanism of cognitive impairment in patients with OSAS is not clear.Our study on the relationship between the early biomarkers of AD and OSAS is of great significance for the further study of the pathophysiological mechanism of AD.To explore the relationship between OSAS and biomarkers related to Alzheimer’s disease in cerebrospinal fluid,we collected the literature on the relationship between obstructive sleep apnea and Alzheimer’s disease,and evaluated the relationship between them by Meta analysis.Methods:The Pub Med,Embase,Web of Science,The Cochrane Library,CNKI,Wanfang and VIP databases were searched for observational studies on the association between obstructive sleep apnea and Alzheimer’s disease published before December 2022.Two researchers independently screened the literature according to the inclusion and exclusion criteria.If the inclusion results were inconsistent,the full text of the literature with disagreements would be reviewed and discussed together,and a third party could be invited for evaluation if necessary.Stata16.0 software was used for statistical analysis,forest map was drawn,and publication bias was detected.Results:After screening,6 literatures were finally included,including 294 OSAS patients and 215 control patients.The data were combined and analyzed,and the results were as follows:(1)Six studies investigated the level of Aβ42 in cerebrospinal fluid(CSF),involving294 patients with OSAS and 215 controls.The results showed that the level of Aβ42 in cerebrospinal fluid of OSAS patients was lower than that of the control group,and the effect value as follows(SMD =-1.00,95% CI:-1.81 to-0.19,P < 0.0001).(2)Six studies investigated the level of P-tau in cerebrospinal fluid(CSF),including294 patients with OSAS and 215 controls.The results showed that there was no significant difference in the level of P-tau in cerebrospinal fluid between the patients with OSAS and the control group,and the effect value as follows(SMD = 0.19,95%CI:-0.17 to 0.55,P = 0.008).(3)Six studies investigated the level of T-tau in cerebrospinal fluid(CSF),including294 patients with OSAS and 215 controls.The results showed that there was no difference in the level of T-tau in cerebrospinal fluid between OSAS patients and the control group,and the effect value as follows(SMD = 0.04,95% CI:-0.14 to 0.23,P =0.116).(4)The level of Aβ42 in cerebrospinal fluid of patients with moderate to severe OSAS was lower than that of the control group,the difference was statistically significant,and the effect size was(SMD=-0.98,95% CI:-1.91 to-0.05,P <0.0001).Conclusion:This study showed that OSAS was correlated with the occurrence of Alzheimer’s disease,and there was A correlation between OSAS and early cerebrospinal fluid related biomarkers of Alzheimer’s disease.Compared with the control group,the level of Aβ42in cerebrospinal fluid of OSAS patients decreased,and there was no difference in the levels of p-tau and t-tau.The level of Aβ42 decreased more significantly in moderate and severe OSAS group.Moderate to severe OSAS may be associated with the early onset ofAD.The study of early biomarkers related to AD in cerebrospinal fluid of OSAS patients is helpful for early intervention of the cognitive effects of OSAS on AD patients.However,considering the quality and quantity of literature,further verification of high-quality studies is needed.