Soluble P-selectin levels in patients with obstructive sleep apnea: a systematic review and meta-analysis

Ding Zhu; Zhibo Xu; Tingting Liu; Yaqing Li

doi:10.1007/s00405-021-06831-4

Soluble P-selectin levels in patients with obstructive sleep apnea: a systematic review and meta-analysis

Eur Arch Otorhinolaryngol. 2021 Dec;278(12):4633-4644. doi: 10.1007/s00405-021-06831-4. Epub 2021 May 5.

Authors

Ding Zhu^{1

2

3}, Zhibo Xu⁴, Tingting Liu⁵, Yaqing Li^{6

7

8

9}

Affiliations

¹ Department of Internal Medicine, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, 310022, China.
² Respiratory Group, Department of Endoscopy, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, 310022, China.
³ Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310000, China.
⁴ Department of Respiratory Medicine, Xixi Hospital of Hangzhou, Hangzhou, 310023, China.
⁵ Department of Respiratory Medicine, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, China.
⁶ Department of Internal Medicine, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, 310022, China. lidoctor03@126.com.
⁷ Respiratory Group, Department of Endoscopy, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, 310022, China. lidoctor03@126.com.
⁸ Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310000, China. lidoctor03@126.com.
⁹ , 1 Banshan East Road, Hangzhou, China. lidoctor03@126.com.

PMID: 33950356
DOI: 10.1007/s00405-021-06831-4

Abstract

Purpose: Obstructive sleep apnea (OSA) patients are at increased risk for cardiovascular disease, stroke, atherosclerosis, hypertension, and venous thromboembolism. Elevated soluble P-selectin (sP-selectin) levels are also associated with increased risk of above diseases. But whether sP-selectin levels in OSA patients are higher than their counterparts remain unclear, since previous studies yielded inconsistent results. Therefore, a meta-analysis is warranted.

Methods: PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible studies. Studies were included if they reported sP-selectin levels of both OSA patients and non-OSA controls. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated to determine the effect sizes.

Results: Nine eligible studies were finally evaluated. When all the studies were pooled, sP-selectin levels in OSA patients were significantly higher than that in controls (SMD = 0.54, 95% CI 0.29-0.78, I² = 66%, p < 0.0001). In the subgroup analysis based on BMI matched groups, sP-selectin levels were significantly higher in OSA patients than that in controls (SMD = 0.52, 95% CI 0.27-0.76, I² = 23%, p < 0.0001). In the subgroup analysis stratified by blood source, either serum sP-selectin levels or plasma sP-selectin levels in OSA patients were higher than that in controls. Moderate-to-severe OSA patients had significant higher sP-selectin levels (SMD = 0.80, 95% CI 0.45-1.15, I² = 67%, p < 0.00001), while mild OSA patients showed no significant difference with controls.

Conclusion: The pooled results reveal that OSA patients have higher sP-selectin levels than non-OSA controls. This conclusion remains unaltered in all subgroups other than the subgroup of mild OSA patients. Additional studies are warranted to better identify the role of sP-selectin as a potential biomarker in OSA patients.

Keywords: Biomarker; Meta-analysis; Obstructive sleep apnea; Soluble P-selectin.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Biomarkers
Humans
P-Selectin*
Sleep Apnea, Obstructive*

Substances

Biomarkers
P-Selectin