Nitric Oxide (NO) Levels In Patients With Obstructive Sleep Apnea Hypopnea Syndrome: A Meta-analysis

Background : The incidence of obstructive sleep apnea hypopnea syndrome(OSAHS)is high at home and abroad,and OSAHS can indirectly increase the incidence of cardiovascular and cerebrovascular events.The pathogenesis between OSAHS and cardiovascular disease is currently unclear.This study may be associated with increased levels of oxidative stress caused by chronic chronic hypoxia and endothelial dysfunction in OSAHS patients.A large number of studies have examined the level of NO in OSAHS patients and attempted to establish a causal link between the two,but the results are highly controversial.Therefore,to further assess the association between serum/plasma NOx levels and OSAHS in patients,we performed a meta-analysis to explore the relationship between OSAHS patients and NO.Method:We searched the Medline,EMBASE,and Web of Science databases.To prevent missing related studies,we also conducted a screening in the reference section.Result: Finally,10 of the 7 studies were included in the meta-analysis in line with our inclusion criteria.The meta-analysis included 408 subjects(250 from the OSAHS group and 158 from the control group).The meta-analysis showed that there was a significant association between OSAHS and serum or plasma NOx levels(WMD =-11.66,95% CI:-17.21 to-6.11;P < 0.01).Serum in OSAHS patients compared with normal controls.Or the concentration of NOx in the plasma is reduced.In addition,the sensitivity analysis results show that after removing a single study or converting REM to FEM,the corresponding conclusions or results are still valid.Conclusion: Although our meta-analysis has shown a reduction in serum or plasma NOx levels in patients with OSAHS,the mechanism of functional impairment of this endothelium-dependent vasodilator should be further investigated.These results indicate that systemic NO production is impaired in OSAHS patients,possibly due to nocturnal hypoxia.More importantly,this meta-analysis showed a high potential risk of sleep apnea and hypoxic-induced vascular sequelae,and provided evidence for further basic and clinical studies of vascular endothelial dysfunction in OSAHS patients.